SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...

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1BANGLADESHCAMBODIANEPALPHILIPPINESinfections (less than 1 per cent) anddoes not have a concentrated HIVepidemic, nevertheless it is vulnerableto an expanded HIV epidemic due tothe prevalence of behaviour patternsand risk factors that facilitate the rapidspread of HIV. The recent BehaviouralSurveillance Survey (BSS) dataindicates an increase in risk behaviourssuch as sharing of injecting equipmentand a decline in consistent condomuse, particularly in sexual encountersamong IDUs and female sex workersin the surrounding urban community.The social and sexual interaction hasraised grave concern for the spread ofHIV infection (Bangladesh SerologicalSurveillance Survey 2006).Large Commercial Sex IndustryThere are over 105,000 male and femalesex workers in Bangladesh. Brothelbasedfemale sex workers reportedly seearound 18 clients per week, while streetbased and hotel-based workers see anaverage of 17 and 44 clients per week,respectively.Condom UseThe BSS (2006-2007) 6 th round dataindicates a significant improvement incondom use was recorded (during lastsex with new client) particularly amongbrothel and street-based sex workers.Condom use was 70 per cent forbrothel workers and ranged between51 to 81 per cent among street workers.8
However, condom use was low amonghotel-based sex workers in Dhakaand Chittagong at 40 and 36 per cent,respectively. Hotel-based sex workersare especially vulnerable to HIV asthey have the largest number of clients.Consistent condom use with regularclients is low for all sub-groups.Sexually Transmitted InfectionsSyphilis rates fell among brothel andstreet-based sex workers in Dhaka andamong IDUs in Dhaka and Rajshahibetween 2004 and 2006. Syphilis rates,however, have remained unchangedfor hotel-based sex workers, male sexworkers, and street based workers inChittagong, indicating the presenceof other risky sexual behaviours thatfacilitate the spread of HIV.Needle-sharing amongInjecting Drug UsersThe seventh round of serologicalsurveillance data shows that there is aconcentrated epidemic among IDUs inone neighbourhood of Dhaka with anHIV prevalence of 10.4 per cent. Thislevel of infection among IDUs posesa significant risk as the infection canspread rapidly – and is spreading –within the group, rather than throughtheir sexual partners, and their clients,into the general population. The BSSdata for 2006-2007 indicates thepersistence of unsafe injecting practicesamong IDUs with the majority stillsharing needles and syringes. Anotherconcern is the significant number ofIDUs who sell their blood commercially.Bangladesh continues to rely on thosewho sell their blood to meet part of thetransfusion needs of its people.Lack of KnowledgeData on knowledge and behaviourindicates that only 17 per cent of themost-at-risk populations have correctknowledge about prevention and areaware of the misconceptions - thatHIV/AIDS is spread by coughing orsneezing or through sharing of food andwater with an HIV infected person. A2005 population based survey amongadolescents and young people (aged 15-24 years) indicated that only one out ofthree males in an urban setting and oneout of four in rural areas had correctknowledge of HIV and AIDS. Amongthe general population, data indicatesthat 59 per cent of ever-married womenand 42 per cent of men of age 15-54 were not able to indicate even onemethod to avoid contracting HIV.Migrant WorksMigrant workers are another importantgroup identified as a priority in theBangladesh National Strategic Planfor HIV and AIDS 2005-2010.Approximately 250,000 people leaveBangladesh for employment every year.The risk is that they will get infectedduring their stay abroad and return toBangladesh where they may transmitthe virus to others, especially theirwives who could in turn transmit theinfection to their babies.Subsequent surveillances show that incentral Dhaka, HIV prevalence amongIDUs rose from 1.4 per cent to 7 percent (up to 10.8 per cent in a particularlocality) during the last four years(2005-2009). The level of the epidemicvaries across different geographic areasas well as different population groups.9
Page 2 and 3: Published by:International Council
Page 5 and 6: Table ofContentChapter Titles Pages
Page 7 and 8: INTRODUCTIONThe 2009 AIDS Epidemic
Page 9 and 10: REVIEW OF LINKAGES BETWEEN SEXUAL A
Page 11 and 12: ROUNDTABLE MEETING ON LINKAGES BETW
Page 13 and 14: Mr Roberto M Ador, Executive Direct
Page 15 and 16: Session 3: Health Systems Strengthe
Page 17 and 18: Model for Public-Private Partnershi
Page 19 and 20: CONCLUSIONSuccessful linkages betwe
Page 21 and 22: INSTITUTIONALCAPACITY FORHIV/AIDS A
Page 23 and 24: AbstractBackground: There are a num
Page 25 and 26: the highest export earnings. The pr
Page 27: grass-roots based service deliveryi
Page 31 and 32: 2and Save the Children, USA, and is
Page 33 and 34: Many important national guidelines,
Page 35 and 36: voluntarily, among project particip
Page 37 and 38: ut all sources have consistently sp
Page 39 and 40: USA) and the World Bank ledconsorti
Page 41 and 42: the Prevention of Parent to ChildTr
Page 43 and 44: access to services for their consti
Page 45 and 46: for planned prevention, treatment a
Page 47 and 48: e accomplished if there is supporta
Page 49 and 50: In addition, not all services canbe
Page 51 and 52: daily lives and take priority overH
Page 53 and 54: Promote the social acceptability of
Page 55 and 56: References20 years of HIV in Bangla
Page 57 and 58: 337
Page 59 and 60: Annex 6: Figure 2: National AIDS Mo
Page 61 and 62: INSTITUTIONALCAPACITY FORHIV/AIDS A
Page 63 and 64: AbstractBackgroundThe HIV epidemic
Page 65 and 66: NMCHCNRHPNSRSHNational Maternal Chi
Page 67 and 68: management system, and health servi
Page 69 and 70: universal access to HIV prevention,
Page 71 and 72: In order to support the linked resp
Page 73 and 74: ased violence, unplanned pregnancy/
Page 75 and 76: The essential services package forr
Page 77 and 78: care, and VCCT and ANC;Family plann
Page 79 and 80:
Strategy for RSH in Cambodia 2006 -
Page 81 and 82:
Logistics management proceduresfor
Page 83 and 84:
ReferencesStrategic Plan for HIV/AI
Page 85 and 86:
INSTITUTIONALCAPACITY FORHIV/AIDS A
Page 87 and 88:
ABSTRACTBackgroundThere are a numbe
Page 89 and 90:
planning products from DHOs/DPHOs.A
Page 91 and 92:
priority. A large part of the preve
Page 93 and 94:
the major breakthrough in linking t
Page 95 and 96:
guidelines especially those related
Page 97 and 98:
Court responded to the petition byi
Page 99 and 100:
34building on the technical strengt
Page 101 and 102:
million from donors. As a percentag
Page 103 and 104:
in hill and mountain districts. Fre
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uilding for home-based care through
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is from GFATM. It sets targetsand d
Page 109 and 110:
SRH and HIV programmes are runverti
Page 111 and 112:
IX. REFERENCES1. Adolescent Health
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BANGLADESHCAMBODIANEPALPHILIPPINES9
Page 116 and 117:
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BANGLADESHCAMBODIANEPALBackgroundTh
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BANGLADESHCAMBODIANEPALPHILIPPINESC
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BANGLADESHCAMBODIANEPALPHILIPPINESt
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BANGLADESHCAMBODIANEPALPHILIPPINEST
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BANGLADESHCAMBODIANEPALPHILIPPINESi
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BANGLADESHCAMBODIANEPALThe protocol
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BANGLADESHCAMBODIANEPALPHILIPPINESP
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