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

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