“Prevention is better than treatment”

Working for CARE BANGLADESH for the last eight years, Sakina Sultana sounds

very enthusiastic talking about the current situation and hurdles that Bangladeshi women face in terms of the awareness of HIV/AIDS.

HIV rates in Bangladesh are low, under 0.1%, however certain population groups, such as people who inject drugs (PWID) are more at risk of HIV infection. “FWID (females who inject drugs) are usually viewed as the most vulnerable, as they are at risk of GBV and HIV. That is they are usually the last to be provided with the drug in a group of drug users sharing needles.” says Sakina.  The prevalence of AIDS is controlled and confined in Bangladesh making the number of HIV positive individuals low but not decreasing. “Donors seem uninterested in providing further funds for this reason”, says Sakina.

Women become victims of gender based violence and inadvertently get infected with HIV for a number of reasons. Often most FWID will resort to sexual acts, unprotected in exchange for drugs or money to buy them. Many men will even inject women with drugs in order to coerce them into having sex. This often makes them victims of gang rapes and other forms of physical assault.  Sometimes it is their own intimate partners who force them to have sex with others for the aforementioned reasons. Most female PWIDs are also victims of gender based violence. The lack of funds has led to a lot of downsizing and closing down of PWIDS centres around the country and currently there are only two such centres for FWID.

“Society stigmatizes and alienates drug users and if the user is a woman, the effects are multiplied that only leads them to relapse again. This is a vicious cycle.” Says Sakina disappointingly. Although Bangladesh's prevalence is not something to be worried about, the fact that it is still present is a matter of concern for those who work closely on these issues. Due to lack of funding, HIV screening is also another factor amongst female external migrants. “Our neighbouring countries have a higher prevalence rate and there is a constant flow of external migrants from Bangladesh. As HIV screening is an ethical issue,  it cannot be done without the consent of the individual and the social stigma related to the disease makes the whole process complicated.” says Sakina. Women make up a significant portion of the cross-border mobile population. The lack of necessary legal documents or proper education makes them easier to manipulate. Many will allow them to cross borders in exchange for sexual favours and reluctance has more so than often resulted in gender based violence.

Projects such as 'Emphasis' that work in cooperation with local NGOs, India, Nepal work on two mobility routes between Bangladesh-India and Nepal-India by delivering focused interventions at source, transit and destination points. A Regional Secretariat is based in Nepal to provide overall program direction and day to day oversight of country level program teams in Bangladesh. The project has yielded significant results supporting the importance of screening but funding is limited to make any big changes at present.

Targeted interventionsto support families of drug users or the users themselves are insufficient in halting HIV infection rates. What Bangladesh needs is comprehensive programming that focuses on high risk groups, as well as the general population especially adolescents. “We are all aware of what HIV/AIDS is but little  is being done to teach the masses about HIV infection and prevention.”