Since 1975, March 8 has been celebrated as International Women’s Day, "WOMEN & HIV/AIDS" the theme of International Women's Day this year."

Selected Facts
The Asia-Pacific region is home to nearly four billion people—roughly 60 percent of the world’s population. Like most of Africa, it has persistent gender inequalities that put adolescent girls and young women at a greater health risk than their male counterparts.

Lack of education and information is prevalent among girls and women.

• About half of adolescent girls in Bangladesh are illiterate. (ARSH)

• 44% of girls and 20% of boys age 15-19 in India are illiterate. (Youth, Gender, Well Being)

• 62% of children out of secondary school in India are girls. In Bangladesh, this figure is 52%.(World Bank 2000)

• More than three-quarters of young women in Bangladesh and two-thirds of those in Indonesia don’t know that a healthy looking person can be infected with HIV/AIDS. (UNAIDS 2002)

Marriage at a young age, frequently to men who are much older and who have or have hadother partners, is common.

• In India, 51% of girls are married by age 18. In Bangladesh, 73% are married by age 18; in Pakistan, 32%; and in Indonesia, 31%. (AGI, 1998)

• Only 7% of married adolescents in India use contraception. (ICRW, 2001)

• In India, 1 in 3 adolescent girls are mothers. (Population Council 2003)

• In India, 13% of deaths of females below 24 years are related to pregnancy and childbirth.(UNFPA 2000)

• More than 90% of women infected with HIV in India are married and monogamous. (JAMA medical news and perspectives)

HIV/AIDS is a growing threat in Asia.

• By the end of 2001, 6.6 million people in the Asia and Pacific region were living with HIV/AIDS, second in number to sub-Saharan Africa. (UNAIDS 2002)

• Less than 1% of India’s adult population was infected with HIV/AIDS in 2001, which may seem like a low percentage. It’s not. One percent of India’s population is nearly four million
people, which means that there are more people living with HIV/AIDS in India than any other country in the world except South Africa. 42% of those living with HIV/AIDS in India are
women (aged 15-45) and children (aged 0-14). (UNAIDS 2002)
Adolescent girls are prevalent in the sex industry, and they are particularly vulnerable to HIV/AIDS.

• About 60% of Indonesia’s 71,000 registered prostitutes are between the ages of 15 and twenty. (Children on the Edge)

• There are an estimated 2 million women involved in commercial sex work in India, one-quarter of them are below the age of 18. (UNIFEM antitrafficking)

• 70% of commercial sex workers in Mumbai are infected with HIV. (TREAT ASIA)

• One in five sex workers in Bangladesh is HIV positive. (UNAIDS 2002) Maternal mortality is high.

• Maternal mortality ratios in the Asia-Pacific region are second only to those in sub-Saharan Africa. In Bangladesh, 600 women die for every 100,000 live births; in Indonesia, 470; in India,
440; and in Pakistan, 200. In the United States, this figure is 12. (UNFPA, 2001; PRB, 2002)

April 2003

HIV Situation in Bangladesh

The information on HIV prevalence in Bangladesh is limited and available data suggests that the overall prevalence is low even among high-risk groups. However, several factors, mainly related to the country's poor socio-economic background, make the country vulnerable to the epidemic.

The data available is sporadic. In 1988-89, sero-surveillance was conducted among several groups of people, sex workers, STD patients, IDUs and antenatal clinic attendees, but no one was found to be positive. In a survey in Dhaka in 1996, 0.2 per cent of the sex workers were tested positive. However, there was no evidence of HIV infection among sex workers tested in 1997 and 1998. In the Central area, 0.4 per cent of the sex workers tested in 1998 were HIV positive.

There was no evidence of infection among STD patients in 1988-89. In 1996, 0.5 percent of patients tested in Chittagong were positive. In 1998, only zero to 0.3 per cent of patients tested positive. In northwest and northeast areas, the prevalence was zero in 1998

In 1998, 2.5 per cent of IDUs tested in the central area were positive. But no evidence of HIV prevalence was available among truck drivers. In one survey, 13% of sex workers reported having injected drugs and that there is widespread needle and syringe sharing. There is evidence of a high rate of syphilis (app. 60%) and other STDs among commercial female sex workers. The rate of condom use is low.

Estimates

BANGLADESH  Figures Value Year Source 13,000 2001 UNAIDS Global HIV/AIDS Report 2002 13,000 2001 UNAIDS Global HIV/AIDS Report 2002 3100 2001 UNAIDS Global HIV/AIDS Report 2002 310 2001 UNAIDS Global HIV/AIDS Report 2002 650 2001 UNAIDS Global HIV/AIDS Report 2002 2100 2001 UNAIDS Global HIV/AIDS Report 2002  Estimated Number of HIV cases (Adults and children)  Adults (15-49 years)  Women (15-49)  Children  Esimated number of deaths due to AIDS  Estimated Number of AIDS orphans

The National Response

In view of the pandemic that started in the early 80s, Government of the People's Republic of Bangladesh formed a National AIDS Committee way back in 1985 for prevention & control of HIV/ AIDS. By now it has completed a Short term Plan of Action, an interim plan of Action and many other activities related to prevention and control of HIV/AIDS. The National AIDS Committee, therefore, considered the necessity for a National policy on HIV/AIDS. The Director General of Health Services, accordingly, formed a 11-member "Task Force" with the Chairman of the Technical Committee as its convener. The Technical Committee was a body of experts supervising technical aspects of HIV/AIDS and STD prevention and control. It is the technical arm of National AIDS Committee. It also provides technical support to the Coordination Committee.

In 1996, the Government of Bangladesh endorsed the National Policy on HIV/AIDS prepared by the multidisciplinary group. In November 1997, the Government issued a Plan of Action to address HIV/AIDS within the framework of the Health and Population Sector Programme. A National Strategic Plan (1997-2002) was issued by the Bangladesh AIDS Prevention and Control Programme (BAPCP) of the Ministry of Health and Family Welfare in May 1997.The National programme has an implementation strategy and a behaviour change communication strategy. Religious leaders, students, youth leaders and community leaders have been involved in advocacy programmes.

Strategies

a. Prevention of sexual transmission: Sexual transmission accounts for most of the HIV infection. Prevention of sexual transmission requires education leading to changes in sexual behaviour that reduce as much as possible the rate of transmission. Educational approaches seek to reduce the number of partners and promote the use of condoms.

b. Prevention of blood related transmission: Transmission of HIV through blood can be reduced or prevented by universal screening of blood and encouraging voluntary blood donation, use of sterile materials for injections, prevention of IV drug use and introduction of universal precautions in the health care setting.

c. Prevention of perinatal transmission: Prevention of perinatal transmission can be achieved by intensive and widespread education of the population of HIV/AIDS.

Reduction of the impact of HIV on individuals, groups and societies: Provision of appropriate counseling and care services is essential to address the psychological and other effects of HIV on both the infected persons, their relatives and the communities. Widespread education and the adoption of non-discriminatory policies are required to provide a supportive environment that will help those affected (whether infected or not) cope with the stress and burden of the situation.

In order to achieve these objectives through strategies mentioned above, the programme activities will be carried out through a 'Tripartite Coalition' among the three main functionaries. I.e., National AIDS Committee (NAC), acting as an Advisory Body, Ministry of Health & Family Welfare (MOH&FW) as the coordinating and supreme Executive Body and, the Directorate General of Health Services (DGHS) and other ministries, directorates and agencies as the Implementing Body.

UN Support

UNDP has been historically the UN agency most involved in supporting the National Response. Currently it is developing activities in the following areas: Support to NAP- staff and capacity building. Blood safety NGO support UNICEF is developing activities in the area of IEC and adolescent health with support from UNAIDS Secretariat. UNFPA is actively integrating HIV/AIDS/STD in the different components of its RH programme. WHO offers capacity building on programme management

Support By Others

World Bank is finalizing a project (US $ 40 milllion) with close involvement of the UN agencies and other partners. The project focuses on: High risk behavior change interventions Advocacy and communication Institutional capacity building. DFID has been supporting the Shaki project of CARE which works mainly with vulnerable populations, but also provides technical and financial assistance to other NGOs. Through its regional approach, DFID seeks to sensitize policy-makers and focus on migration. USAID supports Social Marketing and provides technical and financial assistance to CBOs. Two areas in which USAID has played a key role are behavioral surveillance and mapping of NGO-response to HIV in the country (in collaboration with DFID). More recently USAID has been supporting counselling training.

Source: UNAIDS, C/0 UNDP-Bangladesh

SDNP
Bangladesh