Health And Science Bulletin
Continued efforts to reduce high-risk behaviours are needed
Annual surveillance for HIV infection and risk behaviours has been conducted among populations at elevated risk for HIV infection since 1998. The last round of surveillance was conducted between June 2003 and March 2004. Among the 10,445 persons tested 35 (0.3%) were HIV infected. Among injecting drug users participating in a needle/syringe exchange programme in one city, 4% were HIV infected and in one neighbourhood in that city, 8.9% were HIV infected. Behaviours that can transmit HIV were common. Continued efforts to reduce high-risk behaviours are needed.This round of surveillance among persons engaging in high-risk behaviours in Bangladesh continues to demonstrate a low overall prevalence of HIV infection (<1%). There are, however, two primary causes of concern. First, there is an outbreak of HIV among injecting drug users in one city in Bangladesh. Because people who inject drugs also donate blood and are sexually active, the outbreak represents a broad risk to public health. Second, behaviours that facilitate the transmission of HIV are commonly reported among these population groups that are most at risk. Indeed the high rates of HCV among injecting drug users and the high rates of syphilis among sex workers demonstrate that risky behaviours are frequent enough to transmit pathogens. Unless behaviours change, as the prevalence of HIV increases, a large outbreak of HIV will occur in Bangladesh. Compared to previous surveillance rounds, the current data are notable for the stable overall rate of HIV prevalence but an increase in the proportion of injecting drug users who borrowed a used needle/syringe in the last week from 66 % to 86%. The reduction in the prevalence of active syphilis in street female sex workers of Central City A following intervention suggests that prevention efforts can be effective. Overall, these data suggest that public health efforts to reduce high-risk behaviour should remain a high priority. More effective programmes are urgently required to prevent an epidemic. Source: ICDDR,B
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