Women & AIDS

One sometimes unfortunate aspect of blogging and reading blogs is that we often do not read the comments made to blog posts. Many blog readers do not even look at the comments, or, if they do, it is only to add their own. I believe that this can lead to missing opportunities to learn or dialogue about important issues. That said, I am posting today two of the comments I received to my yesterday’s post, The Dilemma of Compassion:

Socio economic status strengthen of HIV/AIDS in Bangladesh


Ms. Ramya Raina Shruti
Director
TCTD Society
Bnagalore Karnataka
India
shruti_india@walla.com



HIV (Human Immuno Deficiency Virus), the virus responsible for AIDS, is known to be transmitted through sexual intercourse with an infected partner, the use of infected blood, needles or syringes, and from an infected mother to her children. By the end of 2006, about 47 million people worldwide were living with HIV/AIDS, 90% of them in poor and developing countries. During 2000 alone, a total of 5.3 million adults and children were found to be newly infected with HIV, and in the same year, three million people died from HIV/AIDS - 80% of them Africans.


Although at present Bangladesh is categorised as a low HIV prevalence country, from an epidemiological point of view the HIV epidemic in Bangladesh is evolving rapidly. Bangladesh has a relatively low prevalence of less thlan 1 percent among vulnerable groups except in Injecting Drug Users (IDUs) where HIV positivity has rapidly increased from 1.7 percent in 2000/2001 to 4.9 percent in 2004-05 in central Bangladesh. The environmental closeness of Bangladesh to Myanmar and consequently, the Golden Triangle drug trail has made it a major transit route for drug smuggling and its easy availability in the area.


However, the transmission route of HIV/AIDS in Bangladesh is no longer confined to the IDUs but spreads further to the female sexual partners of IDUs and their children. This is not surprising as women are mostly vulnerable to HIV infection and other sexually transmissible diseases because of geographical and socio-cultural factors including economic, educational and legal discrimination and unequal gender relations. The most alarming news is that -- during 5th round of surveillance in 2003/2004 -- in one pocket of central Bangladesh HIV infection rate among IDUs has reached concentrated epidemic level of 8.9 percent. During the sixth round in Central-A1, out of 664 IDUs covered, 7.1 percent tested positive for HIV. On top of that for the first time HIV was detected in cities other than Central-A during the sixth round. These two new places are Southeast-D and Northeast-F1 with the HIV prevalence rate among IDUs at 0.6 percent and 2 percent respectively.


Women are disproportionately infected with HIV/AIDS for biological, social and economic reasons. Globally, 47% of HIV-positive adults are women, but it is increasing rapidly. Certainly, adolescent girls’ prostitution is booming in Bangladesh. Adolescent girls engage or are forced into prostitution for trafficking or socio-economic reasons. But in addition to sexual exploitation, they face all sorts of violence. Rainbow Nari O Shishu Kallyan Foundation carried out a recent field investigation, the research confirmed that adolescents girls’ prostitution is widespread in Bangladesh, although hidden at first sight from foreigners, especially in Dhaka city. Adolescent girls involved in prostitution are to be found in residence homes converted into brothels or in hotels. The majority are aged 15-18.


Higher level of female commercial sex in Bangladesh than elsewhere in Asia: female sex workers in Bangladesh brothels report among the highest turnover of partners anywhere in Asia, at an average of 18.8 clients per week. Averaging 44 clients a week, hotel based sex workers are still higher. This high turnover is very important, because it means that once a woman does contract HIV from any of her clients, she can pass the infection on to a large number of people very quickly as the condom use is still very low while someone buying sex in Bangladesh.


Trafficking is another major problem in Bangladesh, Rainbow Nari O Shishu Kallyan Foundation found, Trafficking is strong link HIV pandemic, if we see; globally of those HIV epidemic region, trafficking & sex exploitation is regular feature of there. Mostly trafficking victim are used commercial sex industry in other geographical area, they stay in there, as like in prison, they have no rights of speak out themselves. They are forced to sexual conduct with multiple partners, but they have no ability to insist upon condom use or safe sex and are vulnerable to HIV/STIs transmission. Some time they have to face physical attack, but they don’t get health care facilities.


References:
1. UNAIDS
2. NASP-GO-Bangladesh
3. Rainbow Nari O Shishu Kallyan Foundation
4. CDC

In response to Ms. Ramya Raina Shruti’s comment, Reverend Sumangali Tania Pink wrote:

I would like to add to Ms. Shruti's post. My dissertation partly involved HIV/Aids issues and human rights in South Africa. I would agree that women are disproportionately affected not only in South Asia but in Africa and the North as well.

But it is not only female sex workers who are at risk. It is all women.

In South Africa, it is compounded by economic issues but also by traditional medicine that fails to see HIV as a medical issue rather than a curse which the women inflicts on her family and her tribe. More, cultural imperatives make it very difficult for a woman to say no to sex or to insist on condom use. To top that off, is a government in complete denial of the issue and failing to follow their own court's ruling to force the government to allow women to be offered single dose treatment (at what is low cost or freely provided by the drug companies) to prevent mother to child transmission of HIV/Aids.

In most of the world, these are privilidges that most women can not rely upon - it is NOT only sex workers at risk!

In the North, women are also disproportionately being infected and again, it is among the poorer sections of society and those cultures where machismo is still highly prevalent that women suffer most.

That being said - it does not detract from this man's or any man's suffering who is infected.

More, I wanted to comment that we might want to avoid thinking that HIV/Aids is no longer a death sentence because of anti-retroviral cocktails. Firstly, that is true only for a small proportion of the worldwide population that is infected, because those in the developing world cannot afford the meds. Secondly, there are developing strains of HIV that are resistent to drugs.

I am also curious to know from Ms. Shruti what the Karnatakan government is doing - and the Indian government in general - about the under-reporting of incidence and rates of HIV infection. Has this been recognised and addressed by the governments for the problem that it is?

As readers of Nick’s Bytes may note, I have addressed the issue of AIDS and HIV numerous times*. My own study of the disease has indicated that the problem the infection and treatment of women is a major concern. Below are some links from my own files which directly relate to the issue of women and AIDS:

Interact Worldwide

CDC: HIV/AIDS and Women

The Well Project

UNAIDS: Women

Women, HIV & AIDS

UNIFEM: Gender & HIV/AIDS

HIV Infection in Women

HIV and Women

International Community of Women Living with AIDS/HIV

Human Rights Watch: Women and HIV/AIDS

UNESCO: a gender-sensitive response to HIV and AIDS

Women, Children, & HIV

Preventing the spread of HIV/AIDS by empowering women in Africa

H.I.V. and AIDS in Africa: Ten Lessons From the Field

UNAIDS: South Africa

POVERTY AND HIV/AIDS IN SUB-SAHARAN AFRICA

With Women Worldwide: A Compact to End HIV/AIDS

Rwanda: "Marked for Death", rape survivors living with HIV/AIDS in Rwanda

HIV/AIDS: Bangladesh

Songs of Life: Women, Girls, HIV and AIDS

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* See below:

Bristol-Myers Squibb "Light to Unite" Campaign for the National AIDS Fund

Remembering a Friend—and a Prayer

Today Is World AIDS Day (2005)

World AIDS Day (2006) "Death by Diplomacy"