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Monday, September 5, 2011

Vulnerability of Nothern Region of Bangladesh for HIV/AIDS

Globally reaching 5% in any high-risk group is consider as an epidemic. It is therefore observed that Bangladesh is still in low prevalence but has the high potentiality of vulnerability. As of this year the total reported HIV positive in Bangladesh is 363 and out of this 57 are AIDS cases of whom 30 patients have died. It is evidence that the main transmission of HIV/AIDS routes in South Asia is sexual intercourse which is 75-80%. The comparative disadvantage of this is that the presence of huge male and female commercial sex workers and low use of correct and consistent condom use are the major threat to combat HIV/AIDS.

The bridging population who are the clients plays vital role in spreading HIV/AIDS. Around 70% of the transport workers like rickshawpullers and trucker’s visits sex workers and have wives at home. As per 4th National surveillance data, the bridging population like Truckers and Rickshawpulers vulnerability are as follows:

     7  percent truckers have the syphilis infection
    65.9 and 67.7 percent of rickshawpullers and truckers respectively bought sex from female partners in the past month
    12.2 and 23.4 percent of rickshawpullers and truckers respectively used condom during the last commercial sex with female  partners
    1.2 and 11.2 percent of rickshawpullers and truckers respectively consistently used condom with female commercial partner during the last year

    14.9 and 15.9 percent of rickshawpullers and truckers respectively bought sex from male/hijra in the past month
    9.8 and 9.8 percent of rickshaw pullers and truckers respectively used condom during the last commercial sex with male/hijra  partners
    1.4 and 4.6 percent of rickshaw pullers and truckers respectively consistently used condom with male/hijra partner during the last year
    20.9 and 60.3 percent of rickshaw pullers and truckers respectively sought STI treatment at formal facilities among those with symptom for last STI.
    4.7 and 40.7 percent of rickshaw pullers and truckers respectively exposed to NGO intervention in past year

Sex workers:
    0.2% street sex workers are HIV positive
    29.8  percent street sex workers have the syphilis infection
    35.6% used condom during the last commercial sex with new clients and 30.3percent regular clients
    only 1.7 to 2.7 percent sex workers consistently used condom with new and regular clients

    40 to 60 percent of this population sought STI treatment at formal facilities among those with symptom for last STI.
    While 20 to 51 percent exposed to NGO intervention in past year

The northern areas of  Bangladesh under Rajshahi Division which has a huge land border with India and as we know that the border are using as a route for trafficking and smuggling.

The areas is the most vulnerable and neglected area in Bangladesh. The reasons of vulnerability in the context of STD/HIV/AIDS are of various and some of them are noted  below:
    Due to river erosion, every year around five thousand number of families migrated to town in empty hand
    Out of eight, four upazilas are surrounded by Indian land and river boarder through where the smuggling are going on and  peoples are visiting each other country
    Due to non availability of job, people are the poorest of the poor and  involve in hazardous job
    As per our recent survey data of our NSDP project, 35% of the total population of this district are ultra poor and 45% are poor
    This district is a flood prone area and  most of the people who has land are dependent on agricultural income
    Due to hard poverty stricken area, women access to job are far cry and therefore involve in sex activities for livelihood
    Since this district is seasonal agricultural based therefore from July to October almost every year there is flood where most of the people do not have any work and therefore “MONGA” slow famine hit the district and starvation is a common issue which is a  big threat to survival.

    Since this northern region is agricultural based, potatoes, rice, vegetable etc. are produced here and these are transported throughout the country by truck. A huge number of inter district trucks moves in this district. Therefore there are huge number of Transport Worker like truckers and rickshawpillers as well as laborers and businessmen who consists a significant number of  total population. This group of population are the major client of the sex workers.

    Due to huge open land border with India, a good number of  people involved in smuggling and also peoples from India and Bangladesh visit each other country  for different purposes. Since India is the second largest  HIV/AIDS affected country in the world ( around 4 to 5 million are positive)  there is every possibility of  spreading HIV/AIDS among the people of Bangladesh.

It is therefore, evident that most of the known HIV-risk behaviors and factors such as, sex workers, presence of high rate of STI/STD, huge number of  transport workers and the important one is the poverty remain present in the proposed working area. As a result, there is an increasing concern that a marked epidemic spread of HIV might occur deteriorate situation. Therefore, it needs immediate attention by the development actors.

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