Near HIV epidemic in high-risk groups in Bangladesh

Pinaki Roy:

The country risks an onslaught of Human Immunodeficiency Virus (HIV) infection, as its prevalence in a particular group of injecting drug users (IDUs) jumps from 1.4 percent in 1998 to 7.1 percent in 2005, reports a survey.

With some 30,000 IDUs across the country, the situation could be even worse, as the survey could not sample most of the possible cases, warns the report of the sixth national HIV surveillance.

The study conducted by the Centre for Health and Population Research of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) categorises the IDUs aged between 32 and 38 years in some districts of Dhaka Division as the most vulnerable to the fatal disease and terms the situation near epidemic.

As the IDUs typically share the same syringe in their groups and often go to sex workers, HIV can very easily be transferred to the sex workers. And from the sex workers, it is easy for the virus to find ways in the general population. Because, the latest behavioural surveillance on HIV found an increase in risk behaviours such as sharing of needles and a decline in condom use in sexual encounters between the IDUs and female sex workers as well as when males have sex with males.

Apart from the IDUs, the survey found heroin addicts, female and male sex workers, Hijras (hermaphrodites), transport and port workers, and poor day labourers as most exposed to HIV infection.

The increasing number of female IDUs is also a disturbing fact, as it heightens the risk of spread of HIV, the report says.

A recent Rapid Situation Assessment (RSA) survey of CARE Bangladesh also found the situation becoming gradually critical due to rising HIV prevalence among the vulnerable groups like the IDUs.

Besides needle sharing, the IDUs in most cases also sell blood to raise money to feed their addiction, posing another threat of spreading HIV. According to the sixth surveillance, approximately 82 percent IDUs shared needles in the previous six months.

While passing by the Dhaka Medical College Hospital, it is common to see a number of ashen skinned, unhealthy people in tattered dirty rags sitting around in scattered groups sharing a syringe or two to get their daily 'fix'. This correspondent somehow managed to talk to some of these people, who admitted to sharing needles now and then for taking drugs.

"Most of the time, we use separate syringes provided by NGO workers. But, we also use the same syringe sometimes," said Islam. He also admitted to selling blood in the past to get money for drugs but said he gave up the practice.

Islam said sometimes they use a large syringe to inject drug very quickly to avoid police hassles. He however refused to tell from where they collect the stuffs.

Since the first case of HIV infection detected in 1989, only 465 cases of HIV infection had been officially reported until December 2004. Last year 198 new cases were reported. Of the HIV positive people, 87 have developed AIDS and 44 died.

On the other hand, even back in 2002 the UNAIDS estimated some 13,000 adults and children were HIV positive in the country, which by now should have increased more.

The experts say significant underreporting of cases occurs because of the country's limited voluntary testing and counselling capacity. According to them, the information available should set alarm bells ringing for the country.

AIDS conditions worrying in Bangladesh

Bangladesh HIV/AIDS Brief

UNICEF Bangladesh - HIV/AIDS