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The information gap on HIV/AIDS/STD among the adolescents, adults and general population including people with risk behavior is high in Bangladesh. About 88% of adult males do not know about the need for prevention and 96% female adults are also ignorant of this. Bangladesh is still considered to be a low prevalence area. But there is enough evidence to suggest that high-risk behavior is being practiced and all the factors for an epidemic do exist.
Unless effective measures are taken with earnestness at once and intervention for vulnerable groups is implemented, an epidemic is likely to spread like wild fire among the general population. Vulnerable groups and high-risk practices in Bangladesh may be summed up as follows:
- At least 80,000 sex workers operate in Bangladesh. The number of street workers and call girls may make this figure even higher than 110,000. Approximately 120,000 truckers operate on long routes and most have unsafe sex during travel halts.
- More adults and adolescents have premarital sex than is commonly believed. Many get infections during their sexual encounter.
- A large number of workers migrate into Bangladesh annually and are involved in unsafe sex.
- There are approximately 15,000 injecting drug users.
- Approximately 220,000 units of blood are required per year, of which 75 percent comes from professional donors. Injecting users constitute 20% of the professional drug-users.
- A large of 25,0000 street children in Bangladesh are sexually abuse.
- The clients of sex workers do not practices safe behavior and get infected with STD and likely carry it to their wives, other regular partners and unborn children. The numbers of clients are much more than any group and they are at the most high-risk situation. These clients and their families reside a ambush in the society and community. So the total community is at great risk in Bangladesh.
Knowledge about safety from infection is scarce. Now is the time to infuse knowledge to all everywhere. If everybody is to be saved, the message of prevention should go to everybody. If we cannot prevent it everywhere we may not be able to prevent it anywhere. The pandemic is an individual behavioral tragedy of ignorance. Studies have shown that an individual as at risk of getting STDs or HIV if exposed to infected blood or body fluids. All these routes need intervention.
Sexual transmission accounts for most HIV infection- about 80%. Since an individual engages in sexual practices more frequently than he or she is likely to be exposed to blood transfusions, the chances of infection of HIV/STD from sex practice are much greater. An intervention in sex practices is the most effective way of preventing the spread of the infection. But knowledge of prevention practices can make individuals refrain from risk behavior.
There are instances that where some are highly sexually active but remain free from infection due to strict adherence to the norms of safe sexual practices. There are also other instances where sex workers are champions of safe sex practices and remaining illness-free for long. It is therefore ideal for the individual to keep his or her body safe from other’s infection.
There are about 4 to 5 million STD patients known to be living in Bangladesh many more are unknown. There is a three-fold linkage of STD with HIV/AIDS. This should be brought home to all so that no further infection occurs and the already infected persons get effective treatment. Now Bangladesh is a low prevalence area. It can be made a no HIV zone if no further infection is allowed to happen. This can be done through accurate and effective messages to all in a short time frame.
Communicating about sexual health and STD is important. The OSDUY supplement this issue by sharing messages with individuals in print materials. The OSDUY has developed a message book with appropriate messages, already approved by the Technical Committee of the national AIDS committee, the STD/AIDS program, the Ministry of Health & Family Welfare, and duly appropriated by the United Nations and used at home & abroad. The programs of distribution & motivation among the population have been running since 1997 in many areas of Bangladesh. The government of Bangladesh has been pleased to accord approval to printing & distribution of 5,000,000 books all over the country.
There are instances where sex workers practice safe behavior but are under pressure to pay additional fees for sex without condoms. So now is the time to transmit the message. OSDUY has been doing this nationally since 1997 through the use of two tools:
- AIDS-Okal Mrityu
- Social groups from among the community
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MZAhsan
Preventing HIV among vulnerable youth through Information, education, communication and motivation on prevention and control of HIV/AIDS/STD among the adolescents, adults and population of reproductive age through hand in hand distribution of message book "AIDS-Okal Mrityu".
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