HIV/AIDS Tips

Gender Knowledge Would Prevent HIV/AIDS

Women Empowerment, Cornerstone of HIV Prevention

Risky Behaviors Fuels AIDS Epidemic in Low Prevalence Country

AIDS ingesting - a major health issue of Adolescents

Teens and Risky Behavior

HIV/AIDS – A Challenge for Women in Bangladesh

Helping Adolescents to Become Sexually Responsible Adults

Stamping out Gender Discrimination to Prevent HIV/AIDS

Community based strategic plan to curb spread of HIV/AIDS

Education as a Vehicle for Combating HIV/AIDS

AIDS, adolescents and preventive education

Building Life Skill through Reproductive Health Literacy -Reduces Vulnerability to HIV/AIDS

HIV/AIDS Prevention through- Qualitative Adolescent Reproductive Health Literacy

Gender Equality, Beacon of Hope for AIDS Prevention

AIDS (Acquired Immune Deficiency Syndrome)  a syndrome caused by the Human Immuno-deficiency Virus (HIV), in which the body's defense system is destroyed resulting in the failure of the body to fight against infection. The syndrome in its final stage is known as AIDS. HIV virus spreads when blood, semen and vaginal fluids of an infected person come in contact with the blood or body fluid, through a breach in the mucous membrane or the skin of another person. Modes of transmission include sexual intercourse; contaminated blood; contaminated needles, syringes and other skin piercing instruments. Vertical transmission from an infected mother to her baby can occur during pregnancy or during delivery or even after birth while nursing.

The first case of AIDS was identified in 1981, in Los Angeles, USA. In 1983 the Pasteur Institute discovered 'AIDS', and a test called the 'HIV test' for detecting the presence of the virus in the body was also developed in the same year. The first case of AIDS in Asia was detected in Thailand in 1984 and by 1986 it had spread to Myanmar and the Indian subcontinent.

In Bangladesh the first case of AIDS was detected in 1989. Till January 2001, seven persons died of AIDS in the country and 150 are carrying HIV. A recent survey conducted on 4,000 people belonging to the high-risk behavioural groups indicates that Bangladesh is on the threshold of an AIDS epidemic. This study undertaken by the International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), and the National AIDS Prevention and Control Programme revealed that out of every 100 intravenous drug users in Bangladesh, two carry the Human Immuno-deficiency Virus (HIV) which causes AIDS.

Apart from this, at least one in a hundred brothel female sex workers, and one in two hundred street sex workers, also have HIV. The situation is aggravated by a low level of understanding of how to protect oneself from HIV infection, as well as poor hygiene, and the sharing of needles by drug takers. It is apprehended that the country may be fast moving towards the kind of AIDS prevalence seen in a number of African countries unless preventive measures can break the trend.

In the initial stage of the disease most (60%) of the patients remain asymptomatic. But in a few cases the patient may develop 'flu' like symptoms after 1-3 weeks. The fever in these cases may continue from 1 to 3 weeks. Weight loss, chronic diarrhoea, and swollen lymph nodes are major signs of AIDS. The HIV virus takes about 3 to 6 months from the time of entering the body to become detectable in the blood. This period is called the window period. In some cases the person may remain in the carrier stage for up to 15 years without developing any sign/symptoms. Of the carriers about 50% after 8 years and 60% after 15 years, develop AIDS. Once developed, AIDS cannot be cured. In the developed countries a person with AIDS may live up to 3 years and in the developing countries up to 1 year. [Md. Shahidullah]

The Purpose of know about HIV/AIDS:

To control the spread of HIV infection within high-risk groups and to limit its spread to the general population, without discriminating and stigmatizing the high risk groups.

Communication and Advocacy

Considering the low levels of prevalence of HIV/AIDS in various sub-populations in Bangladesh it is imperative that preventive action be taken at the earliest. Successful interventions to increase awareness and create support for HIV/AIDS prevention programme are critical for the sustainability of activities aimed at preventing an HIV/AIDS epidemic in Bangladesh.

The National HIV/AIDS Behaviour Change Communication Strategy Implementation Plan for Bangladesh (April 2000) serves as a good framework for action. In the context of the proposed programme, the priority is to develop/expand: (a) a public information programme to raise awareness about HIV/AIDS among the general public and (b) target information programmes with the objectives of demystifying and creating greater acceptance of condom use and disseminating information, including understanding and support for other intervention programmes. All of these are required in order to create an enabling environment for those who will work for HIV prevention programme.

It is important to recognise the need to maintain a careful balance between respecting cultural sensitivities while at the same time promoting effective change. A sequenced phase approach to audience targeting, audience segmentation, message development, delivery channel use, frequency and intensity of message delivery will therefore be a key feature of the strategic thinking under this component.

Why/How can we prevent it?

• Raising awareness, knowledge and understanding among the general population and the key groups who influence or are instrumental to the success of the HIV/AIDS prevention programme;

• Facilitating the adoption of safe practices across the whole society and among specific groups;

• Encouraging the mobilisation of resources and commitment for the implementation of the HIV/AIDS prevention programme; and

• Reducing stigmatisation of HIV/AIDS affected people.

How can we prevent it?

Public awareness and Advocacy:

The objective of this sub-component will be to increase the knowledge and understanding among the general population about HIV/AIDS/STD transmission and prevention and to create support for the HIV/AIDS programme among key groups who influence or are instrumental to the success of the HIV/AIDS prevention programme. It will also seek to create a positive and non-discriminatory environment for people affected by HIV/AIDS and understanding as well as support among the public for GOB and NGO intervention programmes.

The programme will rely on public information programme through the mass dissemination of critical information on HIV. Mass media campaigns will be organised at central and district level using TV spots and programmes, radio, cinema and local cinemas, billboards, leaflets, posters, booklets/books, stickers, collateral materials, cinema slides, newspaper advertisements, traditional folk music and street theatre. Finally the programme will further pilot the establishment of HIV/AIDS hotlines to deliver basic information about HIV/AIDS infection and prevention.

Advocacy campaign both to supportive and key policy makers, journalists and religious leaders and expansion of advocacy efforts to others, e.g., political and social leadership will be conducted throughout the programme implementation period. These activities might include organising events such as conferences and workshops, fellowships and training, including study tours; and observing World AIDS Day. Messages will be based on the HIV/AIDS situation in the world, South and South-East Asia, explain prospects for the spread and prevention of HIV in Bangladesh; and seek understanding and support for GOB policies on HIV prevention efforts.

Cause of Spread out /which group will became host of HIV

• Commercial sex workers,

• Injecting drug users,

• Men who have sex with men,

• Client of sex workers,

• Professional blood donors,

There is no doubt about the need to work with the high risk groups like, commercial sex workers, injecting drug users, men who have sex with men, client of sex workers, professional blood donors, and STD clients to prevent the HIV/STD/AIDS. Current behaviour and surveillance studies indicate clearly the need to initiate interventions with these high-risk groups. The objective of this component is to prevent the emergence of a major AIDS epidemic in Bangladesh by limiting the transmission of infection from those populations with the highest prevalence of risk behaviours to the general population. Prevention of such an epidemic depends on the rapid coverage of those population groups with highest rates of infection and/or at the highest risk of infection and therefore most likely to spread the infection to others. There is however, little consensus on the total estimates and geographical spread of these risk groups within the country. Any planning for intervention in Bangladesh must precede with a mapping and a risk survey exercise. The available information for the best estimates of the numbers in each risk group and the target coverage over the life of the programme is given below. The assistance and experiences of NGOs will be of paramount importance in conducting and implementing the risk group interventions.

Injecting Drug Users: Most of the injecting drug users are in the age group of 25-40 years. Nearly half of them are married. According to the behavioural data available most of the drug users have been injecting for more then 4 years. Most injectors have about 20 shots a week. Needle sharing is quite common. Cleaning practices are not safe. Most of them are sexually active. 19.4% of IUDs had an average of 1.9 non-regular sexual partners. HIV prevalence among injecting drug users is about 2.5% while syphilis is at 12.5%. Some injecting drug users also often donate blood for money. One study conducted by CARE-Bangladesh reports that there are an estimated 25,000 injecting drug users in Bangladesh. Other key informants put the number of IUDs however, at a lower level, around 12,000-14,000. Currently there are 15 sites where various NGO programmes have already successfully reached substantial numbers of this population; perhaps 4,000 with an intervention package including education, enabling environment, condom promotion, needle exchange and STD treatment. It appears feasible for this programme to reach all of these target groups and it is proposed that this be carried over during the programme period.

Female Sex Worker: There are about 17 brothels recognized in Bangladesh. A study undertaken by UNDP of these brothels indicated that there are about 6,000 sex workers living in these brothels. In addition there are a larger number of floating sex workers in these areas who are not brothel based. According to one NGO estimate there are about 8,000 street based sex workers in Dhaka City alone. The best estimate of the total size of this target group defined as those women engaged in commercial sex work 4 or more days a week is about 25,000. Surveillance in one of the brothels in 1998 indicated that HIV prevalence was 1.5%. Syphilis prevalence was reported at about 50%. Sex workers see an average of 2-3 clients per day. There is near consensus among various stakeholders on the need to focus on sex workers. Currently there are 29 sites where different organisations are providing various sexual health services to sex workers. Some progress is evident in providing services to this group, mostly through the NGOs. Most brothels have awareness programmes but initial improvements in condom use and self reported STD levels have not increased. Hotel and residence based workers, the latter of whom are particularly hard to reach, had only one large awareness programme in Dhaka. This programme aims to cover all sex workers over the four year period.

Case Management: Appropriate case management for opportunistic infections amongst AIDS patients will be introduced in all secondary and tertiary hospitals. At early stage, antiretroviral drugs will be used only on a pilot basis. However, adequate drug provision will be made for treating other STIs as well as for opportunistic infections.

Procurement

Major areas for procurement concern condoms, HIV test kits, drugs for STD and HIV treatment, and disposable equipment for the safe handling of blood/injection practice to include needles and syringes. Other items include equipment to strengthen laboratory STD/HIV diagnostic capacity and to strengthen the Programme office. The Line Director for Stores and Supplies will assist the LD, ESP, DGHS with the procurement.

Technical Assistance will be deployed to assist the LD in procurement. The draft Procurement Plan for the year 1 for goods and technical assistance is attached (Annex 6.1-6.4). In procuring goods both the GOB and the IDA guidelines will be followed. The threshold of prior review for the procurement of goods will be agreed during the negotiation of the Agreement.

Aids Research Center

Rainbow Nari O Shishu Kallyan Foundation
24/3 M. C. Roy Lane
Dhaka-1211, Bangladesh
Phone: 880-2-8628908
Mobile: 01711344997
E-mail: RainbowNGO@gmail.com

General Scientific Co.
Motalab Mansion (3rd floor), Room # 408, 2 R.K. Mission Road
Dhaka-1203, Bangladesh
Phone: 9558917, 9562570
Fax: 880-2-9562570
E-mail: salamgsc@bdcom.com

Primco Instruments Ltd.
801 City Heart, 67 Nayapaltan
Dhaka-1000, Bangladesh
Phone: 9336671, 9349657
Fax: 880-2-9338697, 8822670
E-mail: primco@dhaka.agni.com

Prism Scientific Instruments Co.
56 Delwer Complex, Shahid Nazrul Islam Road (Hatkhola)
Dhaka-1203, Bangladesh
Phone: 7110074
Fax: 880-2-9559037

Bangladesh Scientific & Chemical Mart
38 & 26 Shahid Nazrul Islam Road (Hathkhola)
Dhaka-1203, Bangladesh
Phone: 7122615, 7122619
Fax: 880-2-9553058
E-mail: sahmed1@bangla.net

Scientific Bazar (Pvt.) Ltd.
Zakaria Bhaban, 33/2, Hatkhola Road, Tikatuly
Dhaka-1203, Bangladesh
Phone: 7111290, 017-355642
Fax: 880-2-9559037, 9555770
E-mail: milon@vasdigital.com

Source: www.bangla-aids.org