Beliefs, sexual behaviours and preventive practices with respect to HIV/AIDS among commercial sex workers in Daulatdia, Bangladesh

Gono University, Savar, Dhaka 1344, Bangladesh.
Public Health (Impact Factor: 1.43). 06/2005; 119(5):371-81. DOI: 10.1016/j.puhe.2004.08.015
Source: PubMed


Despite the rising prevalence of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) since 1994 in Bangladesh, the World Bank found the epidemic to be preventable provided vigorous and prompt action is taken. High-risk heterosexual contact, especially among commercial sex workers (CSWs), is a major mode of transmission. Formulation of relevant and effective prevention programmes for HIV/AIDS requires better understanding of the knowledge, attitudes, behaviours and practices in the high-risk groups.
A cross-sectional survey comprising face-to-face interviews using a structured questionnaire with items on knowledge, beliefs, condom use and other sexually transmitted diseases (STDs).
In total, 300 CSWs were interviewed between July and October 2000 in Daulatdia brothel. Daulatdia is one of the largest river ports in Bangladesh.
Although most CSWs had heard of AIDS, correct knowledge of transmission and symptoms was lacking. HIV/AIDS was viewed as a remote threat, over-ridden by immediate economic and survival concerns. Although the majority of CSWs knew that condoms afforded protection against STDs/AIDS, only one-third of sex acts on the last day of work were protected through condom use. CSWs who were married, had been a CSW for less than 5 years, were with a new client, or had two or more clients in last working day reported significantly higher condom use. Client dissatisfaction was the major reason for not using condoms. Many did not obtain treatment for STDs in a timely fashion, if at all.
Bangladesh needs a comprehensive HIV programme that combines clinical and screening measures with behaviour change and communication interventions, along with change in social norms and attention to the rights of CSWs in order to avert a widespread epidemic.

38 Reads
  • Source
    • "That means prostitutes have the legal authority to practice their trade in Bangladesh and this is highly unusual. It makes Bangladesh one of the few Muslim majority countries that does not ban prostitution (Hosain & Chatterjee, 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The children of sex workers in Bangladesh are denied even the most basic human rights. This article is based on recent research focused on the children of sex workers in the context of their everyday lives. The study focused on access to education and how education could be a vehicle for them to break the vicious cycle of exploitation. This was a mixed method interpretative study which employed qualitative and quantitative approaches, but in this paper only qualitative data which was generated through in-depth interviews and focus group discussions is used. Data was collected from sex workers, their children, teachers and NGO workers who participated in the study. Information has been collected for analysing the expectation of the children of sex workers and hope for the future, and the opportunities available to them during their schooling. Thematic analysis technique was used to understand the challenges and barriers faced by the children of sex workers in fulfilling their educational aspirations. The lives of the children of sex workers are marginalised by the mainstream society. Though it is very difficult to break the vicious cycle of exploitation, this research finds that education may be a stepping stone for them to create a better future. However, it is argued that the children of sex workers need income generating vocational and technical education to enable them to earn and support their family. Policy recommendations have been made in order to achieve Education For All (EFA) targets and Millennium Development Goals (MDG), and to provide a second chance for these vulnerable young people to have a better life.
    02/2013; 3(1):13-31. DOI:10.5723/csdc.2013.3.1.013
  • Source
    • "Carrying condoms also invites harassment from police (22). It is encouraging that several community-based groups of sex workers have been formed, in recent years, advocating for their basic rights as citizens of Bangladesh (22). This is likely to improve their well-being generally and also increase healthy behaviours, such as consistent and correct condom-use. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Bangladesh has maintained a low HIV prevalence (of less than 1%) despite multiple risk factors. However, recent serological surveillance data have reported very high levels of HIV infection among a subgroup of male injecting drug-users (IDUs). This suggests that an HIV/AIDS epidemic could be imminent in Bangladesh. Although biomedical and behavioural change projects are important, they do not address the root causes of observed risky behaviours among 'high-risk' groups. In Bangladesh, these groups include sex workers, IDUs, males who have sex with males, and the transgender population-hijra-who are all excluded groups. Using a social exclusion framework, this paper analyzed existing literature on HIV in Bangladesh to identify social, economic and legal forces that heighten the vulnerability of such excluded groups to HIV/AIDS. It found that poverty and bias against women are major exclusionary factors. The paper presents areas for research and for policy action so that the social exclusion of high-risk groups can be reduced, their rights protected, and an HIV epidemic averted.
    Journal of Health Population and Nutrition 08/2009; 27(4):587-97. DOI:10.3329/jhpn.v27i4.3404 · 1.04 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Heterosexual transmission accounts for the majority of cases in India, an epicentre of the HIV/AIDS pandemic, with increasing rates of infection in married women contracting HIV from an infected spouse. Cultural roles and position of married women in Indian society render targeted risk-reduction programmes difficult. To investigate HIV/AIDS-related knowledge, perceptions, and behaviour change among married women in India, an interview-based survey was conducted with 350 married women in Mumbai, of whom 67% (236) were aware of HIV/AIDS. Although 59.3% (140) of those aware mentioned indiscriminate sexual activity as increasing risk of HIV, only two (41%) in five women perceived HIV as a threat to the community; one (12%) in eight perceived personal risk of getting infected as high; and only 7.2% (17) reported behaviour change to avoid infection. When probed for reasons for not changing behaviour, most women cited their personal behaviour of monogamy, not being in an at-risk group, such as commercial sex workers, and trust in their husbands. Education programmes among married women that enable better understanding of risks are urgently required. Since marriage and motherhood are important in the Indian cultural context, male spouses should be included in risk-reduction programmes.
    Journal of Health Population and Nutrition 04/2006; 24(1):81-8. · 1.04 Impact Factor
Show more