The prevalence of HIV is monitored annually among specific groups at sentinel sites spread across the country. Behaviours that carry a risk of HIV infection are evaluated in tandem. Syphilis and hepatitis C HCV are also monitored as surrogate markers to corroborate behavioural data regarding unprotected sex and unsafe injections.
In addition, particular population subgroups, such as regular partners of sex workers or mobile men, including truckers and rickshaw-pullers, who may eventually be the source of spread of the epidemic into the general population are evaluated.
However, the HIV epidemic in Bangladesh is evolving rapidly. The surveillance data for each of the population groups will be discussed in the relevant sections. IDUs are very vulnerable to an HIV epidemic, and this is the group in which the virus has been detected repeatedly.
In Dhaka, data from research and from the surveillance showed that the HIV epidemic was localized in a specific neighbourhood which could be considered to be the epicentre of the epidemic 14 , All sources of data on risk behaviours confirmed very risky injection-sharing behaviours among IDUs sampled from different cities.
The average size of the sharing network for those IDUs who shared the last time varied from 1. Similar data were obtained from the male cohort study in Dhaka. In the cohort at the baseline, The most common reason cited for sharing despite being in the NSP was not having access to sterile needles at the time of injection In addition to risky injection practices, data showed that IDUs were also practising unsafe sex.
Of those buying sex, Women who use drugs are known to be further marginalized and stigmatized and, as a result, are more vulnerable to HIV. Very little is known about female IDUs in Bangladesh, and intervention programmes are not accessing them in large numbers. We, therefore, attempted to set up a cohort of female IDUs from three cities—Dhaka, Tongi 27 km to the north of Dhaka city , and Narayanganj 23 km to the southeast of Dhaka city.
All women aged 15 years and more with a history of injecting drugs at least once in the last six months were eligible for enrollment, and they were accessed with the help of outreach workers from the NSP of CARE Bangladesh, through the networks of female and male drug-users and that of female sex workers. During December —March , female IDUs were enrolled in a cohort study, and the same study provided data for surveillance.
At the baseline, none had HIV but The majority Of them, 60 were married but only 28 were living with their spouses. Attempts were made to identify the injection-sharing network of the HIV-positive IDUs by asking them who they had shared their injections with and where their partners could be found. Through this network, 96 sharing partners who were not already members of the cohort were identified and enrolled. Of them, Networking is a very effective way of reaching IDUs and may be considered a strategy for interventions as well.
However, the rise in HIV prevalence is slow. To explore whether these better-than-expected results are related to the intervention activities, a mathematical modelling was conducted to estimate the impact of the NSP of CARE Bangladesh in Dhaka The model was then used for estimating the impact of intervention on HIV transmission among IDUs and their sexual partners.
Surveillance for risk-behaviour has, however, shown that there is much cause for concern. High-risk behaviours, including anal sex, and group sex were also common. Somewhat encouraging has been some increased use of condoms, at least in some groups Also, there has been a reduction in syphilis rates in female sex workers over time A qualitative study was conducted in to explore the patterns of condom-use among a sample of hotel-based female sex workers and their male clients who claimed to have used a condom during the last commercial sex act Three specific patterns of condom-use were identified.
Some clients started intercourse without a condom, but put one on before ejaculation, some started intercourse with a condom, but took it off after a few minutes or just before ejaculation, and others started intercourse with a condom and continued until the end. These findings question whether simply promoting condoms will effectively prevent the transmission of HIV.
Several separate surveys on STIs have been conducted with different groups of female sex workers. All showed high levels of different STIs, many of which were asymptomatic 22 - But these NGOs do appear to be making a difference as the behavioural surveillance data comparing sex workers in and out of interventions showed that those sex workers in interventions were practising safer behaviours Behavioural Surveillance Survey data have consistently shown that risk-behaviours in both male sex workers and Hijra are very high.
Hijra reported a very high average number of clients 30 in the last week. Condom-use was not common. Active syphilis rates remained similar in male sex workers but declined in Hijra over the rounds although the rates in Hijra were higher Fig. A qualitative assessment of male-to-male sex was conducted in Chittagong in , and one of the aspects explored was why men sell sex.
The study showed that most men who sell sex, similar to most women who sell sex, did so for economic reasons. A common voice supported this assumption:. I feel pain during sex. I actually do not enjoy sex with men. I also face various types of violence. I cannot disclose my sex sell pesha to anyone in my family or society. I know this is an extremely bad behaviour. The Almighty Allah will punish me. I have no education. Who will give me job? I am a poor man; I cannot do any business either.
How can I survive? I tried other daily labour to earn a living. But it is very difficult to survive. I found that selling my own body is a much better way to earn money.
Every night I earn at least taka. No one knows my source of income. I keep it hidden. A survey of men in this category was undertaken to better understand these behaviours and attitudes. For the behaviour surveillance, the MSM group is defined as males who have sex with other males but do not sell sex. A recent study using a new sampling methodology, Respondent Driven Sampling RDS , which is deigned to obtain a random sample from hidden populations, revealed that MSM in Dhaka are highly networked Although there were differences within the various geographic regions of the country, many of these men were also purchasing sex from males or Hijra.
Group sex was reportedly common. Condoms were almost never used during sex. A large proportion of MSM had female sex partners or was married. A qualitative study attempted to understand the nature of the relations of MSM with women It was found that these men feel societal pressure to marry, become husbands, and become fathers.
In , a situational assessment of the Chittagong port was conducted to gather information on the behavioural factors contributing to the risk of HIV infection in the port city of Chittagong, Bangladesh, for the immediate objective of designing an HIV and STD-prevention programme The populations included men from various trades in Chittagong and male and female sex workers. The study demon-strated an extensive clandestine sex trade in Chittagong.
Traffickers brought women from Burma and the tribal areas of Bangladesh. Child prostitution was also common. Fishermen, dock-workers, and rickshaw-pullers represented major client groups, followed by local and foreign sailors and truckers.
This study formed the basis of assessing the vulnerabilities of mobile populations in the surveillance system of Bangladesh through which dock-workers, truckers, rickshaw-pullers, and launch-workers were sampled in different rounds from different cities. HIV has not been detected in any of these groups sampled over the different rounds of surveillance with the exception of one rickshaw-puller out of sampled in Dhaka during the 5 th Round of the serological surveillance — Clients of sex workers are largely derived from the general community of men.
Proportion of men who reported sex with different types of sex partners other than wives in the last year in different studies conducted by ICDDR, B. The study was conducted during September —August In addition, the non-profit status of the legal applicant if applicable will be verified along with its ability to fiscally manage federal funds. Applications submitted by eligible coalitions that demonstrate they meet all requirements will then be scored through a peer review process according to the evaluation criteria described in the Application Review Information of this FOA.
Each year, DFC recipients must demonstrate compliance with all of the Statutory Eligibility Requirements to be considered for continuation funding. The intent of the DFC Support Program is to fund coalition activities in the United States and does not authorize the funding of organizations or activities outside the United States.
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Skip to main content. Mono Bar U. Main menu. Territories for mental and substance use disorders. Ellos escuchan. They Hear You. Solr Mobile Search. Drug problems manifest in local communities and show up in our schools, churches, health centers, and in our homes. The DFC Program helps local leaders organize to identify the youth drug issues unique to their communities and develop the infrastructures necessary to effectively prevent and respond to the disease of addiction.
The latest reauthorization extends the program until Grants have been awarded to communities from every region in the nation and include rural, urban, suburban, and tribal communities.
The FOA, when open, is posted on Grants. Community coalitions meeting all of the statutory eligibility requirements can apply during the open period for funding. DFC grants are awarded for five years with a maximum of 10 years.
New grants represent those openly competing for their first or sixth years of DFC funding, while Continuation grants represent "in-cycle" grants in years or of DFC funding. DFC Continuation Mentoring grants represent the second year of the two-year award. Community-based coalitions that meet all of the statutory eligibility requirements can respond to the annual Funding Opportunity Announcement FOA. Skip to main content Skip to footer site map. FY DFC Applicant Workshops: Applicants applying for the first time Year 1 , current recipients applying for a second cycle of five years of funding Year 6 or former recipients who experienced a lapse in funding during a five-year cycle, are encouraged to attend one of the following pre-application workshops.
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