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Situation Analysis
AIDS is a global problem and it is also a development crisis. In Bangladesh 386 HIV positive cases have been detected so far. Out of them 57 AIDS cases were detected of whom 30 have already died. The situation in Bangladesh is characterized by low prevalence but high risk of HIV, high prevalence of STI, unsafe sex practice and low level of awareness among general mass.
Lessons leaned from other affected countries advice that early action is essential to stop the spread of HIV at large. Service integration and partnership with other organizations would be essential and most cost effective option for a country like ours with limited resources to stop the virus from spread, before the economic burden becomes too large to endure.
Problem Analysis
• Low level of awareness still prevails in Bangladesh. It is difficult to generate awareness about the risk associated with HIV transmission due to conservative social environment that restrict free and open discussion of sexual issues, to reach more vulnerable group is made difficult by the atmosphere of stigma, denial and discrimination.
•National behavioural surveillance found that large number of men continued to buy sex at higher percent than anywhere else in Asia. Majority of men still do not use condoms in commercial sex encounters and female sex workers reported the lowest condom usage in the region which is around 4%. Evaluation study of FPAB also found that consistent condom use among the CSW is 8%.
•The fourth round of serological surveillance has detected 4% HIV infection among high-risk behaviour group in Bangladesh just short of the 5% mark of a concentrated epidemic. The syphilis rate is also high; studies reveal that among female sex workers the rate is as high as 40%.
• Studies also found that increasing trend of premarital and extramarital sexual behaviour also exist in Bangladesh.
•Poor Access to quality STI/HIV/AIDS related services
•The 1999 to 2000 BDHS found that only 33% married women and 50% married men have knowledge on prevention of HIV-AIDS. Very high numbers of respondents from different groups in the third surveillance are not knowledgeable about the basic modes of HIV transmission, which is 93.97%.
• Study found that service-seeking behaviour related to RTI/STI/HIV/AIDS is not satisfactory. It is also found that some service provides still have negative attitude towards STI/HIV/AIDS, which hinders in providing quality STIs/HIV/AIDS related services and the dual role of condom is not well discussed in the counselling sessions. Women status in family, community and society at large is not satisfactory and majority of women are not empowered in decision-making.
• Integration of gender sensitive STIs/HIV-AIDS related preventive services with other projects of FPAB and partnership among different organizations working in the field of HIV-AIDS is still inadequate.
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