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International Journal of STD & AIDS

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Int J STD AIDS 2008;19:327-331
doi:10.1258/ijsa.2007.007269
© 2008 Royal Society of Medicine Press

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Original research articles

Bangladesh moves from being a low-prevalence nation for HIV to one with a concentrated epidemic in injecting drug users

T Azim MBBS PhD * , M Rahman MBBS PhD {dagger}, M S Alam MBBS DPH *, I A Chowdhury MBBS MPH {dagger}, R Khan MSc *, M Reza MSc *, M Rahman MBBS PhD *, E I Chowdhury MSS *, M Hanifuddin MBBS MPH {ddagger} and A S M M Rahman FRCP §

* International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B); {dagger} Institute of Epidemiology, Disease Control and Research; {ddagger} National AIDS/STD Programme; § National AIDS Committee and National AIDS/STD Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of Bangladesh, Mohakhali, Dhaka, Bangladesh

Correspondence to: Dr Tasnim Azim, HIV/AIDS Programme, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) Mohakhali, Dhaka 1212, Bangladesh Email: tasnim{at}icddrb.org

Bangladesh has been conducting annual serological surveillance for HIV and syphilis since 1998 among most at-risk populations including sex workers, males having sex with males, injecting drug users (IDUs) and heroin smokers. During the seventh round conducted between January and June 2006, 10,368 people were sampled and the overall HIV prevalence was 0.9%. The highest HIV rate was recorded in male IDUs from the capital city Dhaka (7%), and the rates have risen significantly over the rounds (P < 0.001). In Dhaka, most of the HIV-positive IDUs (10.5%) were localized in one neighbourhood, while in the remaining neighbourhoods 1% were positive (P < 0.001). In all other groups, HIV prevalence was <1%. Active syphilis rates were highest in female IDUs (9.9%) followed by female street-based sex workers (8.6%). However, rates in female sex workers in Dhaka declined significantly over the years (P < 0.001). Bangladesh has to act urgently to prevent escalation of the epidemic.

Key Words: HIV • syphilis • injecting drug users • sex workers • Bangladesh


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