The New Nation - Internet Edition

A H M Abdul Hai

Many of the civilians still question the HIV/AIDS prevention, treatment, care and awareness activities, terming it 'an excess hue and cry' of the government and non-government organizations across the country. A higher official of a ministry opined, through talking much about HIV/AIDS, NGOs are tickling the public interest towards risky practices including sex and drug. "Why are there innumerable NGOs working on HIV/AIDS issues?", he asked.

Talking to Sakib (Not real name), a smart young man of a rich family in Dhaka, it is observed, he does not bother about any risk of HIV/AIDS, though he has been habituated to having sex with at least five married female partners for last six years. He claims that he and all of his sex partners do never care about AIDS preventive measures. They did never use condoms and even do not think it necessary. But it is easily possible that the young man and his sex partners might be infected with HIV/AIDS in a cyclic order. Any or some of the house lords of the partners might have had HIV by visiting brothel or any type of sex-workers. They are coming back home and using their wives. Thus our sons, daughters, brothers, sisters-all are vulnerable for HIV/AIDS infection, because no body is revealing his or her sex partners and sex-history to others. Extra-marital sex cases are disclosed only in some lower class families. What about the sex-cases of the middle and upper-class people? Nothing of the risky sex practices and injecting drug using of the elite and middle class people is disclosed in Bangladesh. Members of these families are having sex with house-based and hotel-based sex workers or might be termed as sex partners. These sex workers and sex partners are also serving in the beds of our foreign guests and tourists, many of whom are carrying the virus from their own country.

A higher official of NGO Affairs Bureau said, recently a large number of NGOs have applied for registration, while most of them wrote about their work on HIV/AIDS field. "Why is it happening?", he asked, "Is HIV/AIDS so alarming in Bangladesh and how is it?" He also asked, if it is very alarming, why we do not find any news story of death caused by AIDS in the newspapers. Such a high profile official of the government has all the scope to know about AIDS policy and program of the government and NGOs, but they do not concentrate to the issue ignoring it as the issue of NGOs for financial benefit. He or they, the upper class people, do not know that HIV/AIDS is not only a health issue, it is rather a social issue, an economic issue and a human rights issue as well. They do not care and know that HIV can embrace all type of people irrespective of age, class, caste, color, gender and religion. HIV can grace the rich and the poor similarly.

A mother of a upper-class family tore the advertisement page of Sananda off as there was an advertisement of condom, so that her young son, student of a university, might not get the page. This is the real situation in our country. The terms HIV, AIDS, STI, STD, sex, condom are still 'taboo' to most of the people here. They know little of these serious issues but can not utter these words in front of their son, daughter, brother, sister, parents or guardians.

It was known from a reliable source, a college student of Mohammadpur area in Dhaka had at least six male sex partners and even she practiced having sex with more than one male partners together without any condom. This girl is going to get married with some other young man. In this way, some or most of them are going to be infected by HIV/AIDS in a cyclic order. But no incident of such an unsafe sex practice will be disclosed as it is a Muslim country and we believe that we have some basic moral values to be maintained. Many of us remain aloof from this issue just believing that all people are here Muslim, so they are chaste, pious and honest and they can not be of promiscuous character.

Another case study, more usual in Dhaka, less usual outside, shows that in the patriarchal society, Azizul (not real name), a husband aged 41 years living in Rangpur area, has been maintaining extra-marital sex with at least three girl friends for last eight years. It is an open secret to his wife. But she has nothing to say, because she can not do anything and go any where without his monetary support. That is why, with much agony and grief his wife has also chosen a young man aged 38 years as her sex partner secretly. In this family picture, Azizul is receiving STIs and HIV from his girl-friends, he is giving it to his wife and thus it spreads to her extra-marital sex partners. The same situation is prevailing in the families where husbands are working abroad and they are not meeting their wives for six months to three years.

Here is the situation more fatal as expatriate husbands are maintaining extra-marital sex-practice in those countries and their wives have the same sex-practice here. That is why we see time and again some Bangladeshis are identified as HIV positive in the foreign land and they are forcibly returned home. They are coming back and having sex with their wives and spread it at large. The vulnerable situation of such an extra-marital sex practice does not come to light as these characters always pretend to be honest, pious and chaste.

Though pre-marital and extra-marital sex-practices are in such a risky level in Bangladesh, no bride or bridegroom dare demand HIV test prior to the marriage. So the question easily comes ahead "Who is and how much aware of HIV/AIDS in Bangladesh?" It clarifies that the NGOs and Government programs could reach only limited community members such as brothel-based and hotel-based sex workers, Injecting Drug Users of drug-dens and a few of internal migrants. But a large portion of common people are left unaware and untouched. The Bangladesh Demographic and Health Survey 2004 shows, in last two decades several crores of Taka had been spent on "Awareness Raising and AIDS Prevention". However, only 22/% of the population is aware of HIV/AIDS. In the same survey, it was found, only 60% of women and 42% of men have heard of AIDS. One third of men could not name a single method of avoiding HIV. Only one in ten men knew that limiting to one partner could reduce the risk of HIV transmission. In addition, a large majority of respondents have not heard of STIs at all, which accounted for more than 70% in all categories interviewed. There are known to be significant barriers to condom use in the whole country. These include the perception of men that it reduces sexual pleasures, is barrier to closeness and associated with promiscuity and illicit sex. There is also the embarrassment associated with the purchase of condoms. A survey also found that 18% of sexually active male adolescents had sexual intercourse with sex workers. Among the married male, 36% is reported having pre-marital sex.

While commenting on the 7th National Surveillance Report, former Programme Manager of National AIDS/STD Program (NASP) Dr Abdus Salim says, "HIV prevalence rate in Bangladesh is below 1 percent but risk practices and environment for infection are rampant here." He says that Bangladesh is geographically also at risk of AIDS. Long border area, sex trade, labor migration as links between most at risk population and general people together with gender discrimination, poverty, low level of education, high level of drug addiction among youth, inadequate health service and lack of awareness about HIV/AIDS, which promote infection of this virus, are still prevailing in the country. UNAIDS and World Health Organization, in 2004, expressed their concern that Bangladesh has about 14 - 15 thousand HIV positive people, but NASP estimates the number of HIV positive people in Bangladesh is 7,500. Government did not accept the UNAIDS statistics without any proven ground.

It is very noteworthy in the present national perspective that, while preparing voter ID and national ID card for the people, the Government can easily accomplish all five tests including HIV/AIDS status and mention blood group in the ID cards at the same time. Because, till now Government can not strongly claim any accuracy of their own data of 874 AIDS cases when crores of people are beyond the access of having HIV test. Moreover, it will be a great achievement if Government introduces HIV test in every seaport, airport and land ports just now to combat HIV/AIDS infection through external migrants.

Being afraid of the article to be over-loaded by only a lump of data and figures, it has been limited to the boundary of analyzing root-level and hidden but real situation of sexual vulnerability keeping other vulnerable behaviors left aside. It is with the view to storming the brain and thought of the countrymen and policy makers to address the newly-discovered areas and fill in the loop-holes concerning HIV/AIDS prevention, treatment, care and awareness issues. Otherwise, it will be late when the AIDS bomb is blasted and positive people will be explored in a geometric rate of multiplication.

[Writer is a freelance journalist)