Geographical location of Bangladesh and vulnerability to AIDS

Geographical location of Bangladesh and vulnerability to AIDS-Mohammad Khairul Alam

Bangladesh, with a population of 136 million, had about 13,000 adults and children living with HIV infection at the end 2002, according to UNAIDS estimates. However, only 248 HIV cases have actually been reported. Significant underreporting of cases occurs because of the country's limited voluntary testing and counseling capacity and the social stigma, which leads to the fear of being identified and detected as HIV positive.

The HIV-prevalence rate among adults between the ages of 15 and 49 is still relatively low, at 0.1 percent of the population. As expected, rates are higher in specific groups, such as injecting drug users who have left treatment (1.7 percent) and commercial sex workers (0.5 percent), according to a national behavioral and serological surveillance undertaken in 2001.

Although overall HIV prevalence is low, behavior patterns and extensive risk factors that facilitate the rapid spread of the infection are prevalent, making Bangladesh highly vulnerable to an HIV/AIDS epidemic. These risk factors are gender discrimination, A large commercial sex worker/ brothel sex worker, a large number of hidden/residence sex worker, Lack of basic sexual knowledge, Lack of proper knowledge of sexually transmitted diseases(STDs/STI) etc.

There are fourteen government reputed brothel in Bangladesh, where roughly 40,000 sex workers live in there, the number of per sex worker’s client/customer is 18.8 per week, and 44 clients per week for hotel-based workers. And non countable client meet to residence sex workers or street sex worker, who are very vulnerable for HIV/AIDS. Significant prevalence of sexually transmitted diseases (STDs) among sex workers in Central Bangladesh. About 43 percent of female sex workers and 18.2 percent of male sex workers have syphilis. This and other STDs facilitate the spread of HIV infection and serve as indicators for low condom use and other high risk sexual behaviors. The majority of brothel-based sex workers report at least some sex without condoms with their clients. Among the clients, such as rickshaw pullers and truck drivers, about 83 percent have never used condoms when buying sex.

Now a day Injection Drug Users are increasing all over in Bangladesh. In Central Bangladesh, among 93.4 percent of over 500 injecting drug users, needle sharing is routine. These drug injectors are not an isolated population—they are often married and sometimes sell sex to customers and their own blood to hospitals and clinics.

Lack of knowledge may be creating most problems for Bangladesh of HIV/AIDS epidemic in future. While knowledge of HIV is nearly universal among sex workers and their clients, it is extremely low among the general population. In 1996-97, only 19 percent of women who have been married and 33 percent of men had ever heard of AIDS. In 2001, many still could not identify the basic routes of HIV transmission.

By keeping South Africa outside, India has the largest number of people living with HIV, estimated at 5.1 million (range: 2.5 million – 8.5 million) in 2003. Most infections are acquired sexually, but injecting drug use is playing a bigger role than previously thought. It is also a great threat for Bangladesh, because every day a large number of people are going to India for various reasons. Bangladesh has twenty custom and immigration point in the border with India, and Indian track crosses of this border every day with loaded goods. But Indian track drivers are highly infected HIV/AIDS. So it is also creating the scope of scattering HIV/AIDS in Bangladesh.

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