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AIDS: A weapon of mankind destruction

Monday, 20 August 2007


M. C. M. Lokman Hossain
AIDS is a devastating worldwide pandemic, impacting not only those who are infected, but also their families, the society, the healthcare system and the national economy. Typically HIV/AIDS affects young and middle-aged adults -- 10% of HIV infections occur in individuals 50 years and older (CDC). Gender inequity, poor status of women, lack of proper sexual (safe-sex) and reproductive knowledge, risky behaviour, sexuality and age are important factors, causing such vulnerability.
Gender inequality or unequal power in sexual relations leads to the sexual double standard which has alarming implications for both men and women's ability to prevent the sexual transmission of HIV. Bangladesh is a male-dominated society and violence against girls and women remains a problem. Unequal power relations between women and men, for example, may render young girls or women especially vulnerable to coerced or unwanted sex, and can also influence the capacity of girls or women to influence when, where and how sexual relations occur.
Traditionally the family system of Bangladesh is male dominated and violence against girls and women remains a problem. In societies where girls and women are not empowered to develop life skills, such as problem solving, decision making and critical thinking, they lack self-efficacy and are much more at risk to acquiring HIV. An increasing number of women and girls may be driven into sexual bondage because of poverty and thereby putting themselves and their clients at risk of HIV transmission.
Tradition and poor economic conditions were some of the reasons for early marriage in rural Bangladesh that led to the high rate of maternal mortality. Early marriage is rampant because parents want to get their girls married as early as 16 so that they can inherit family's property. A girl of 14 or 16 years is not mature enough to become pregnant and it could lead to hypertension and eclampsia. This circumstance creates many complexes, which help to make women less practical in society.
In general women have less access to information and education and are therefore less able to make an informed response to the disease. A survey by Association for Social Advancement & Rural Rehabilitation (ASARR) of 400 married women in four Districts in Bangladesh showed that only one in eight women heard of AIDS and even then with a very weak knowledge of its transmission and prevention. Thus, poor knowledge of HIV-AIDS in Bangladesh by the population at large contributes to the tenuous situation. According to recent survey by Rainbow Nari O Shishu Kallyan Foundation, 80% of those surveyed believe that adolescent need more information about HIV/AIDS. As a result of the lack of accessible and appropriate information, fear and stigma are common reactions surrounding the virus and infected persons.
Down to the nature of commercial sex workers' (CSWs) job, the lack of reproductive health awareness and low acceptance of condom use, CSWs represent a highly vulnerable group in Bangladesh. The sharp rise in sexually transmitted infections (STIs) in Bangladesh contributes to the spread of HIV and may lead to a large-scale epidemic, as the heterosexual mode of transmission accounts for an increasing percentage of HIV transmission. There are indications of an increased number of young people who are transgender or transvestite, who are involved in selling sex. Very little is known about their circumstances, specific needs and ways in which services could be made accessible and appropriate for them. However, rather than seeing this group as totally distinct in terms of needs, it is important to recognise them as children, and structure work and offer services that derive from common basic principles and standards.
Bangladesh is geographically vulnerable to HIV/AIDS due to its close proximity to parts of India and Myanmar with generalised epidemic and Nepal that has a concentrated epidemic among injecting drug users. These borders are porous at several places with legitimate and informal traffic crossing both ways. Trafficking of adults and children across these borders is also significant. The highest level of infection ever in Bangladesh was found among injecting/ intravenous drug user (IDUs) in central part of Bangladesh 4.0% in the fifth round national serological surveillance. Sharing of needles and injecting equipment was common among them 77%. The potential is great for HIV to spread in a geometric proportion from IDUs to the bridging population because IDUs are not an isolated group. Rather, they are mobile group, sexually active with married partners, commercial and non-commercial female partners.
The writer is Deputy Director of Finance, Asian University of Bangladesh Uttara, Dhaka and can be reached at e-mail: [email protected]