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Despite being a low HIV/AIDS prevalence country, Bangladesh has all the characteristics of high-risk behaviors for initiating an HIV/AIDS epidemic. This includes considerable high prevalence of pre and extra-marital sex, low condom use, less awareness but significant prevalence of STIs, low knowledge of HIV/AIDS prevention, high prevalence of STIs among sex workers, existence of needle/syringe sharing among drug users and high prevalence of HIV infection among injecting drugs users.
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Gender-based violence (GBV) is commonly thought of as an issue affecting primarily women and girls; however, stigma, discrimination and violence are also expressed toward men who have sex with men (MSM), male sex workers (MSW) and transgender (TG) individuals. While there is an increasing body of research among sexual minorities identifying the association between GBV and physical and mental health issues, including increased risk of contracting HIV, programs for these populations tend to focus on raising HIV awareness to reduce sexual risks. A better understanding of GBV among MSM/MSW/TG populations is necessary in order to develop clear and targeted recommendations for future interventions targeting this issue.
This technical brief is designed for people who are planning to respond to the needs of transgender people for the very first time. The audience may include transgender community members; staff of donor agencies; health workers; academics including researchers and staff of training schools for doctors, nurses, counsellors and other health workers; carers; policy-makers; nongovernmental organization (NGO) and community-based organization activists; lawyers; school teachers and administrators; and staff of police, military, immigration and other authorities.
The Judicial Dialogue provided a critical opportunity for experience sharing between members of the judiciary and representatives of judicial training institutions from 16 countries across Asia and the Pacific, on the complex legal and human rights issues raised by the HIV epidemic. The Judicial Dialogue also benefited from the perspectives of people living with HIV, representatives of communities of men who have sex with men, transgender people, sex workers and people who use drugs.
The overall purpose of the assignment was to build an evidence-base for improving universal access to HIV prevention services, rights and social protection services for hijras/transgender people.
The first case of HIV in Bangladesh was detected in 1989.2 Since then, the number of HIV cases has grown to an estimated 7,500 in 2011. This represents less than 0.1 percent of the total population. In 2011, the National AIDS / STD Program (NASP) reported 445 new cases of HIV, 251 new AIDS cases and 84 AIDS related deaths. Thus the cumulative number of reported HIV cases to date in Bangladesh stands at 2,533, AIDS cases at 1,101 and deaths at 325.
The first case of HIV in Pakistan was diagnosed in 1987. At the end of 2009, Pakistan had an estimated 98,000 people living with HIV. Until recently Pakistan was classified as a low prevalence high risk country. Now Pakistan is considered to be in a concentrated phase of the epidemic. The concentrated HIV epidemic is primarily among high risk populations, with injecting drug users (IDUs) exhibiting the highest HIV prevalence (27.2%) in 2011, followed by Hijra or transgender and male sex workers (MSW s) at 5.2% and 1.6%, respectively. Female sex workers (FSWs) exhibit a prevalence of 0.6%.
Since the first reported case of HIV in 1987, Sri Lanka has had a low prevalence of HIV with less than 0.1% of its adult population living with HIV as of December 2009. As of the end of 2011, Sri Lanka has reported a cumulative total of 1,463 HIV cases with 146 new cases being reported in 2011.
This meeting report highlights the discussions held with lesbian, gay, bisexual and transgender (LGBT) and AIDS advocates regarding the current epidemiological situation of HIV among gay men and other men who have sex with men (MSM), how to improve their access to HIV treatment, and the health and human rights challenges they face. The report also highlights recommendations made by participants to help inform the actions to be taken by UNAIDS and partners in meeting the HIV treatment and health needs of gay men and other MSM.
The objectives of the workshop were to identify the laws hindering the AIDS response and build consensus on reforms needed to create an enabling legal environment for access to HIV services and to chalk out a time bound action plan identifying priorities for the amendment of punitive and discriminatory legal environment that are impeding AIDS responses.
The consultation was attended by 82 participants. The inaugural session, which was attended by eminent personalities, expressed the need for the timely intervention, while the overview of the HIV/AIDS epidemic in Bangladesh painted a vivid picture to the participants in understanding the gravity of the AIDS epidemic and limitations of the current response.