The first case of HIV in Bangladesh was detected in 1989. Since then, the number of HIV cases has grown and by December 2009 an estimated 6,300 adults and children were living with HIV [1]. In 2009, new HIV infections were most commonly found among those aged 26-35 years (32%), while children (aged 0-15 years) and young people (aged 16-25 years) accounted for 4% and 20% of new cases, respectively.  Sixty-eight per cent of new cases were among males. In 2010, the National AIDS/STD Program (NASP) reported a cumulative total of 2,088 HIV cases, and a total of 343 new cases, 231 AIDS cases and 37 AIDS-related deaths [2]. HIV prevalence has remained low, at less than 0.1% in the general population in 2009 [1].

According to the 2007 HIV Sentinel Surveillance (HSS) Round 8, HIV prevalence was 0.3% among female sex workers and transgender (hijras). Prevalence was reportedly much lower among men who have sex with men (MSM) – 0% for MSM in Dhaka and 0.3% in a combined MSM and male sex workers (MSW) sample in Chittagong [3].  HIV prevalence remained very low among MSWs over the rounds of surveillance - 0.7% in 2006 and 0.3% in 2007 [4].  On the other hand, the explosive escalation of the epidemic among injecting drug users (IDUs) and its spread into other population sub-groups has changed the status of the epidemic to "concentrated”. HIV prevalence among IDUs was 1.2%, with low rates found in drug users from five cities [3]. In the 5th Round of the serological surveillance (2003-2004), HIV was not detected in any of the mobile populations except for one rickshaw-puller (out of 401 sampled) in Dhaka [5].

While Bangladesh continues to be a low-prevalence country, its population is highly vulnerable. Specifically, risk behaviours – including high levels of unprotected sex with commercial partners and unsafe injecting practices – are of concern. Condom use in Bangladesh is reportedly the lowest in Asia, although the figures have been rising due to interventions by non-governmental organizations [6]. Furthermore, a range of structural factors heighten the vulnerability of the general population to an HIV epidemic. Bangladesh is a poverty-stricken country with poor rankings for most of the global development indicators and about half of the population lives on less than one dollar a day [7]. Other structural factors include: a low adult literacy rate; low social status of women and the trafficking of women into the commercial sex industry; high population mobility within the country, including interstate and rural-urban as well as international labour migration, particularly across its porous borders with India and Myanmar, both of which are experiencing concentrated epidemics [8].

Sources:

[1] UNAIDS, Report on the Global AIDS Epidemic, 2010

[2] Bangladesh, Ministry of Health and Family Welfare, National AIDS/STD Programme (NASP) Report, 2010

[3] National AIDS/STD Programme, Ministry of Health and Family Welfare, and Government of the People’s Republic of Bangladesh, UNGASS Country Progress Report: Bangladesh, 30 March 2010

[4]  National AIDS/STD Programme ,National HIV Serological Surveillance 2006, 7th Round Technical Report and National HIV Serological Surveillance 2007, 8th Round Technical Report

[5] National AIDS/STD Programme (2005) National Strategic Plan for HIV/AIDS 2004-2010. Dhaka: Directorate-General of Health Services, Ministry of Health and Family Welfare. 2005

[6] Sadhana, R., Sanghamitra, l. (2008). Review of Existing and Emerging Patterns of Sex Work in Bangladesh in the Context of the HIV and AIDS. Regional Support Team, Asia and The Pacific, UNAIDS. 2008

[7] WHO. World Health Statistics. 2009

[8] Rout Sadhana, lyengar Sanghamitra. Review of Existing and Emerging Patterns of Sex Work in Bangladesh in the Context of the HIV and AIDS. Regional Support Team, Asia and The Pacific, UNAIDS. 2008