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HIV threatens sexually active children and adolescents in Bangladesh

© UNICEF/BANA2010-00946/Siddique
Adolescent girls meet at a UNICEF supported Kishori Club where they discuss various social issues such as HIV/AIDS, early marriage and eve teasing at Kulalpara, Holudia, Cox's Bazaar Sadar, Bangladesh.

By Vanessa Curney

DHAKA, 22 November 2011 A study* disseminated in Dhaka has found that children as young as 10 are increasingly at risk of contracting HIV because of their risky sexual behaviours, with services failing to reach the younger, more vulnerable groups. The survey on young people most at risk and especially vulnerable to HIV was conducted by the Nielsen Company, on behalf of the Bangladesh National AIDS/STD Programme, with UNICEF support.

The two part survey focuses on 64 districts. It suggests that those engaged in certain sexual activities within the 10-24 age group may be a small and often hidden section of the population, but that a small number of young people at high risk of HIV becomes significant in a country where the average age of the population is 24 or 25, acknowledged Mr. AKM Amir Hossain from the Ministry of Health and Family Welfare.

Bridget Job-Johnson, UNICEF HIV and AIDS Specialist, stated that there had been limited studies on Most-At-Risk Adolescents (MARA) in Bangladesh, and that the typical lack of age disaggregation of data makes it impossible for impacts of HIV on adolescents to be visible.  She believes that data, when disaggregated, becomes more meaningful. “The figures about HIV risk and vulnerability amongst our young people are trying to tell us something, to warn us, and we need to take them seriously” she said.

The survey includes most at risk young people as:

  • injecting drug users and those who use non-sterile injecting instruments;
  • non-injecting drug users such as heroin addicts;
  • males who have unprotected sex with other males;
  • transgender men;
  • females and males who are involved in sex work;
  • males who have unprotected sex with sex workers.
© UNICEF/BANA2008-00705/Noorani
A peer educator speaks to a group of commercial sex workers during a behavior change communication session inside the Kandhapara Brothel in the city of Tangail.

Risky sexual behaviours within the home

There is a low prevalence of HIV and AIDS in Bangladesh but there is also an uneasy complacency - perhaps denial - about its existence: parents don’t want to acknowledge that adolescent sons (and daughters) may be influenced by brothers, cousins and friends to take drugs or to have sex at an early age. The virus not only targets those being exploited and trafficked for sex but also stalks students, the highest users of sex workers according to the findings of the study. In fact, the significant numbers of these middle and upper class students engaging in sex buying and non-injecting drug use challenges the assumption that most at risk young people are purely of low or no education.

Nonetheless, children who live and work in the streets and in slums are especially vulnerable adolescents (EVA-YP) who have sometimes (though not always) been forced into sex and drugs, and lack knowledge about preventing HIV and sexually transmitted diseases or of how to access HIV prevention services. And even if they do manage to access these services, they can find that their age specific situations aren’t addressed. Again, young people sometimes do not use services because of the criminalisation of the HIV risk behaviours they are engaging in. Men who have sex with men was proved by the study to be a closed and particularly hard to reach group.

The researchers hope the study will pave the way for more meaningful discussions in Bangladesh about HIV and young people not only in Dhaka but other districts such as Chittagong and Mymensingh, which have high numbers of young injecting drug users. “We need policy and a supportive environment to give these boys and girls more options for their lives” says Yasmin Siddiqua, Client Service Director at Nielson.

The final report will be released in 2012

*Mapping, Size Estimation and Behaviour Survey of HIV Most at Risk and Especially Vulnerable Adolescents and Young People in specific Urban/Semi Urban Locations of Bangladesh



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