About the Authors: Monjur Ahmed serves as Project Management Assistant for Communication in USAID/Bangladesh's Office of Population, Health, Nutrition and Education, and Linda Quamar serves as Development Outreach and Communication Assistant in the USAID/Bangladesh Program Office.
Kajol, like many other young women from rural Bangladesh, came to Dhaka in search of employment. With the false promise of employment, she was abducted and forced into the sex trade. Later, Kajol came across one of the U.S. Agency for International Development's (USAID) HIV Prevention peer educators and was encouraged to leave her profession to pursue "a different life which would offer her acceptance and respect in the society." Presently, Kajol works as a trainer for commercial sex workers (CSW) in USAID's HIV Prevention Center which works primarily with hotel-based sex workers in Dhaka. She believes that being a former sex worker has helped her better understand and relate to care-seekers and train them on safe sex methods. Kajol is now happily married to the "love of her life" and has been a part of USAID's HIV Prevention Center for several years.
In Bangladesh, USAID's HIV Prevention program, Modhumita (meaning "dear friend"), focuses on improved prevention, as well as care and treatment services, for at-risk Bangladeshis. Through a network of 54 health centers, USAID provides HIV-prevention services that reach almost 30 percent of all high-risk Bangladeshis, including injecting drug users, male, female, and transgender sex workers and their clients, migrants, and HIV-positive people.
The U.S. government has provided more than $20 million to support Bangladesh's response to the HIV/AIDS health challenges. This has contributed to a prevalence rate of less than one percent in Bangladesh -- well below many of its neighbors. However, there are reasons for concern. Over the last few years, Bangladesh has seen prevalence rates go up among the most-at-risk-populations (MARPs). For example, HIV prevalence among injecting drug users in Dhaka now exceeds five percent, exacerbated by high risk sexual behavior, including low condom use and needle sharing. Other factors contributing to Bangladesh's HIV/AIDS vulnerability include a sizable migrant worker population, and cross-border interaction with higher-prevalence regions in neighboring countries.
Many Bangladeshis become HIV-positive while working overseas. To address this, USAID, in partnership with the International Organization of Migrants (IOM), provides HIV prevention programs for returning migrant workers. Returning migrants who test positive have access to our support programs, including treatment of any sexually transmitted infections.
In addition, through the National AIDS and Sexually Transmitted Diseases (STD) programs of Bangladesh's Ministry of Health and Family Welfare, the Government of Bangladesh (GOB) leads efforts to stem the spread of AIDS by providing resources for prevention, care and support, and advocacy. USAID partners with GOB to build the capacity of the public sub-district health centers in Bangladesh to work in high migration areas. Also, USAID works with health facilities at the sub-district level to integrate HIV/AIDS services and provide improved diagnostics and HIV counseling packages -- all leading to better case management practices.
USAID's health centers provide integrated services including a full-range of family planning, maternal health, general consultation, and diagnostic services. For example, recognizing that people with HIV are more likely to be affected by tuberculosis (TB), USAID expanded support services to include TB screening, diagnosis, and treatment.
USAID's HIV Prevention Program also emphasizes on behavior change communications. Through television talk shows, lectures at mosques, and training sessions, USAID aims to increase HIV prevention awareness while reducing stigma and discrimination. Realizing that capacity building of local organizations is equally important, USAID supports many local non-governmental organizations (NGOs) in improving their quality of HIV prevention and management information systems.
The U.S. government remains committed to HIV prevention and support to the people of Bangladesh. There are many vulnerable Bangladeshis, particularly sex workers and injecting drug users, who are yet to be reached with sexual health counseling, contraception, and testing services for HIV and other STDs -- and USAID's HIV Prevention Program strives to reach them.