Mohammad Khairul Alam

Although Bangladesh continues to be a low prevalence area, it is surrounded by high prevalence countries (High prevalence of HIV/AIDS in neighboring India). We however must not adopt a complacent attitude in respect as our country has all the determinants for an explosive outbreak of HIV/AIDS epidemic. Curses of poverty, illiteracy, ignorance, proximity of Bangladesh to the so-called 'Golden Triangle' & high prevalence of STDs, make our country seriously vulnerable. Drug use increases the HIV risk and can start very early-for example, glue-sniffing by youngsters living or working on the streets. The danger of becoming infected with HIV by sharing injecting equipment is well known, and real. Unemployment, slum housing, family fragility, frequent cross-border movement of people, lack of information, unsafe blood transfusion, physical and sexual abuse-that create a "risk environment" of violence for many young people in the region. In addition increased number of migrant workers, unsafe practice in health service, unsafe sex practice etc. movement of population, less use of condom, polygamy, homosexuality, extra-marital relations, further increases the susceptibility. 

In Bangladesh, the intravenous drug users (IDU) are the most potential carriers of HIV/AIDS among the vulnerable groups in the country. Bangladesh has no official data on drug users. By the way, according to CARE estimates, there are more than 5,000 intravenous drug users and at least 18,000 heroin users in the capital, Dhaka, alone. The fourth round of national HIV and behavioral surveillance report showed that the HIV infection rate among the injection drug users (IDUs) is now 4 per cent, up from 2.5 per cent previously which is just short of the 5 per cent mark of a concentrated epidemic. About 93.4 per cent IDUs in central Bangladesh admitted that they share same syringe while taking drugs. Even they use the same syringe several times for taking drug. 

Although HIV rates are comparatively lower (one per cent) among the sex workers but Sexually Transmitted Infection (STI) rates are still quite high (20 per cent) among this group. On the other hand, brothel-based female sex workers in Bangladesh report the highest turnover of clients than anywhere in Asia (an average of 18.8 clients per week). Certainly, adolescent girls’ prostitution is booming in Bangladesh. Adolescent girls engage or are forced into prostitution for trafficking or socio-economic reasons. But in addition to sexual exploitation, they face all sorts of violence. Rainbow Nari O Shishu Kallyan Foundation carried out a recent field investigation, the research confirmed that adolescents girls’ prostitution is widespread in Bangladesh, although hidden at first sight from foreigners, especially in Dhaka city. Adolescent girls involved in prostitution are to be found in residence homes converted into brothels or in hotels. The majority are aged 15-18.

Meanwhile, most of the people of country are unaware about the deadly disease. By a study of, Rainbow Nari O Shishu Kallyan Foundation in mid-2006 at Kamrangir Char, Lalbagh and Polashi in Dhaka city, surveyors interviewed 430 general population engaged in rickshaw-pulling, selling tea, cosmetics and garments, and hawking goods door to door. They found almost all of the respondents were migrants from rural areas, most of whom were illiterate. Among all respondents 26% claimed to have knowledge on HIV / AIDS and 74% did not have any knowledge. Some 40% of the unmarried respondents maintaining consent sexual relations.

According to the National AIDS Committee and surveillance team members and experts, the rate is quite alarming as it remains one per cent less than the highest five per cent HIV epidemic index. The rate of HIV/AIDS remains less than one per cent among the other vulnerable groups -- truckers, migrant workers, gay, hijras (hermaphrodites), professional blood donors, heroin smokers and, hotel, brothel and street based commercial sex workers. 

About 13,000 to 17,000 people are living with the incurable virus in Bangladesh, according to the UNAIDS report 2001. Bangladesh is bordered with India, the second largest HIV infected country in the world; the country is therefore at high risk for the HIV epidemic, said Morten Giersing, UNICEF's country representative.

References: UNAIDS, Rainbow Nari O Shishu Kallyan Foundation, CARE

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