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

voluntarily, among project participantsparticularly the at-risk population.SRH documentation does not includeissues of HIV apart from some specialprogrammes for special groups ofpeople. CARE Bangladesh has createdpositive but not significant change forMSMs, SWs, IDUs and PLHIV. Thereis a need for more policy support fortheir right to health services, especiallyHIV services, and the reduction ofviolence.Within the broader HIV operationalplan, there are explicit activities toimprove access, coverage and qualityof SRH services to the generalpopulation, and target populations(e.g. MSM, SWs, IDUs, young peopleand PLHIV). At present the GoB isplanning to mainstream HIV, STI,and SRH services within all healthservices.The SOP makes clear reference toconfidentiality and disclosure for HIVrelatedservices. Confidentiality ismaintained for every case. Priority fordisclosure is at the total discretion of theclient. Some respondents reported thecontinued existence of discriminationwith regard to testing and support todisadvantaged groups (e.g. children,orphans, street children, and women),although the consent for HIV testingof adolescents is mentioned in thestrategy.In the National Youth Friendly HealthSurvey standard, training manuals andnational curriculum address the issuesrelated to HIV for minors and youth.Married, unmarried and minors haveaccess to VCT centres that are beingrun by different NGOs in the country,which helps to create opportunitiesfor knowledge disbursement amongthe MARP. “Youth Friendly HealthServices” and “Access to Condoms forYoung People in Bangladesh” in a senseis a stand-alone initiative. However theGoB may include it in the NationalHealth Policy or even in the NationalOperational plan.There are strong legislative and policyframeworks for effective action on bothHIV and SRH, and the promotion andprotection of sexual and reproductiverights. Laws related to issues thathave implications for HIV, AIDSand SRH (e.g. gender-based violenceand sexual coercion, discrimination,early marriage, widow inheritance)help officials to monitor human rightsviolations of MARPs. Civil societies,media, activists and professionalsregularly collect and share cases relatedto human rights violations. Networksof PLHIV and other groups (MARPs)also publish such cases regularly intheir newsletters, in an effort to movetowards a rights-based approach andensure equity of services. Nevertheless,the criminalisation of some riskbehaviours associated with HIVtransmission (sex work, illicit druguse) is impeding the implementation ofother HIV-supportive policies. Furthercoordination with law enforcementagencies and the criminal justice system,with strong support and commitmentfrom the highest levels of government,is still needed.Majority of respondents both from GOsand NGOs said that documentationshows that there are bi-directionallinkages between SRH and HIV15