HIV/AIDS becomes progressively concentrated among poor populations in the less developed countries. Although, the developed countries learn to protect themselves and have the resources to make HIV/AIDS into a chronic, not deadly, disease, but the poor remain vulnerable. This is both a result of the characteristics of poverty itself -- low education level, gender discrimination, stigma, limited access to HIV/AIDS related information or to health services -- and the consequence of the lack of finance to fight the disease.
Poverty and gender discrimination are both strongly linked to the spread of HIV/AIDS. The poor regions in Africa, about 8.0 per cent of all adults in this age group are HIV-infected. About 14,000 infections each day in the world and more than 95 per cent of these new infections occur in the developing countries -- nearly 50 per cent among women. Gender and age analysis shows the ways in which women and girls of various ages are vulnerable to the infection and in need of support to enable the survivors to overcome the economic and social effects of the epidemic. In fact, HIV/AIDS and poverty alleviation strategies are inter-connected.
Women empowerment can prevent gender discrimination, which justifies a holistic approach of policies and programmes to reduce poverty and address HIV/AIDS.
For example, poverty leads women into unsafe sexual encounters, and speeds the onset of AIDS-related illnesses. Violence against women and girls is common in societies with high instability or conflicts. All these factors establish the fact that more females than males are being newly infected every day. It also indicates that women are more likely to contract HIV and fall sick with AIDS at a younger age than men.
Recently, 'Rainbow Nari O Shishu Kallyan Foundation' has focused mostly on three types of work on HIV/AIDS in Bangladesh -- community mobilisation for prevention through promotion of fidelity, condom-use and abstinence; advocacy on access to affordable treatments, targeted at medicine producers and international donor organisations; and work to ensure 'mainstream' support to AIDS-affected individuals and communities for integration in poverty mitigation work. HIV/AIDS has intricate relation with poverty and gender inequality. Without decline in gender discrimination and poverty, all efforts to prevent HIV/AIDS or sustainable development in this sector will fail.
In prevention strategies, adolescent girls do appear as a target group. The education sector, and schools in particular, should be often a major target for HIV/AIDS prevention programmes, via sex education and knowledge of condom-use. We have also to address or find out those who didn't get chance to enrol themselves in these institutions. We have to evolve different strategies to reach the messages to them.
In addition, health education programmes which aim to empower women and girls to use condoms, often fail adequately to tackle the actual problems because of imbalanced power relations.
The desired changes in the behaviour of adolescent girls and boys cannot happen without programmes addressing such issues like how a girl can say no, but also why boys, teachers and other adults should respect the human rights of girls.
Health and education sectors can work together to develop prevention programmes in schools/colleges, which enhance awareness of gender inequality among boys and school/college staffs, as well as girls themselves.
Such programmes also need to expand beyond the school boundaries to reach adolescent girls and boys who do not attend school or college or have dropped out. This may help reduce girls' continuing vulnerability to violence, coercive sex and HIV infection.
Bangladesh, HIV incidence is low, including among sex workers as with other populations. However, the incidence rises dramatically among those who use intravenous drugs.
There are fifteen brothels, where 38000 sex workers are registered, and several NGOs regularly screened for various STDs, the few found to be HIV positive reported that they were drug users or had sexual partners who were. Unprotected sex between sex workers and their clients, needle sharing and unprotected sex between men may make Bangladesh a vulnerable region.
In view of the threat of AIDS and its possible fatal consequences, all communities and NGOs involved in providing preventive and curative health services should give top priority to STD/STI and HIV/AIDS preventive services, and increase the required resources sufficiently.
There is also an urgent need to integrate reproductive health services with the current family planning and maternal health services to expand their accessibility mainly to women.
The writer is AIDS Researcher of Rainbow Nari O Shishu Kallyan Foundation