The findings in this report are in general very encouraging as it shows that the overall prevalence of HIV in populations most at risk remains below 1% and most importantly, HIV prevalence has declined among people who inject drugs in Dhaka from 7% to 5.3%. Moreover, hepatitis C has also decline which is a marker for unsafe injecting practices. Thus, the data suggest that our intervention programmes are having a positive effect. Overall the most number of HIV positive people, irrespective of population groups, were in Dhaka despite the decline in the proportion of HIV positives among people who inject drugs.

Globally, an estimated 17 million women and girls are living with HIV, and more than two million pregnancies occur amongst HIV-positive women each year. In 2009, an estimated 370,000 children acquired HIV. While the total number of children being born with HIV has decreased due to the increased access to services that support women living with HIV to have HIV-free babies (usually referred to as prevention of mother-to-child transmission to PMTCT), the majority of remaining cases occur in resource-poor nations.

In Bangladesh it is widely acknowledged that drug use is increasing and accompanied with this are various risk behaviors. Particular concerns are injecting drug use and adverse health consequences such as blood borne viruses specifically HIV/AIDS and Hepatitis C.

The category “men who have sex with men” (or males who have sex with males - MSM) was developed in response to a recognition that not all male-to-male sexual behaviours falls within a framework of sexual orientation or identity. Within this behavioural category there are multiple frameworks of male-to-male sex, including those who self-identify as homosexuals/gay men, males who self-identify within a gendered framework, such as kothis and hijras, as well as normative males from the general male population who sexually access such gendered males, along with others, usually as the penetrating partner. Male-to-male behaviours also exist in a range of all-male institutions and occupational groups including prisons, juvenile homes, and the armed forces, along with truck drivers, and in other service industries. In this context, the sexual practice is primarily based on a lack of access to females, “body heat”, and immediate discharge. Further to this, there is also a concept of masti, or play, in which same sex behaviours are not seen as “real sex” but play. Significant levels of adolescent males and young men engage in this behaviours.

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To generate knowledge on sexual risk behaviour and practices, condom use, STI symptoms and STI disease burden among youth clients of female sex workers in Dhaka.

Clients of sex workers have been identified as a bridging population for the HIV/AIDS epidemic in Bangladesh. Youth-friendly health services need to be strengthened to offer STI management and STI/HIV counselling services to youth. Appropriate strategies for targeted intervention among clients of sex workers need to be evaluated and implemented.

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In 2000-2001 the HIV prevalence rate among injecting drug users (IDUs) ranged from 1.4 - 1.7%. By 2003-2004 the HIV prevalence had increased to 4 % among IDUs
in Central Bangladesh. In one neighborhood of Dhaka it was 8.9% and this indicates a concentrated epidemic of HIV among IDUs in Dhaka City has commenced. The
National Strategic Plan for HIV/AIDS 2004 - 2010 has as an objective of the need to provide Support to the Priority Groups of People and one focus is to Provide
Support and Services to Drug Users. Five strategies for drug users had been developed and endorsed. It was felt that based on the five strategies, a comprehensive harm reduction strategy is needed to address the situation. The National AIDS/STD Programme of Bangladesh took initiative to develop a draft National Harm Reduction Strategy (NHRS) with technical assistance from UNFPA. The completed draft NHRS will provide the impetus and guidance to seek solutions to address the rapidly rising prevalence of HIV/AIDS among drug users and in turn will attempt to prevent the virus from spreading outwards to the wider community.

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The National AIDS/STD Programme (NASP) of the Ministry of Health and Family Welfare, Government of Bangladesh, played the role of the main coordinating body through taking leadership in the process of preparing the Global AIDS Response Progress Report, 2012, Bangladesh.