Share and Enjoy
Sushmita S Preetha
Mamun (not his real name), 16, says he uses a new needle every time to inject analgesic drugs into his bloodstream.
“Well, not every time,” he confesses, after close questioning. “Sometimes, when I am in a group, and if there is a shortage of needle, and it appears too much trouble some to get a new one, I do share it with others,” he says.
When asked if he has ever been tested for HIV/AIDS, Mamun laughs it off. He admits, however, that he has partaken in unprotected sex in the recent year.
Young, impressionable and impulsive, Mamun seems oblivious of the fact that his imprudent acts make him, his drug-addicted friends, and his partners particularly susceptible to HIV/AIDS.
All over the world, HIV/AIDS infection is the highest among people between the ages 15-24. In fact, 33 percent of the total population living with HIV/AIDS globally belong to that age group. In Bangladesh, too, adolescents are particularly vulnerable due to a series of complex factors, but there is no official or reliable statistic to denote the actual number of infected adolescents.
“In the national survey, only people who are above 20 are counted. That is a serious limitation,” says Dr Tajudeen Oyewale, Chief, HIV/AIDS, UNICEF Bangladesh. “We have to find a systematic way to track and support the adolescents who are infected as well as ensure that those who don’t have it remain safe.”
It is also possible that a considerable number of infected adolescents, in the absence of mass awareness on HIV and easily accessible test facilities, are actually ignorant of their positive status. Like Mamum, they can then unconsciously spread the virus to their peers and partners, thereby putting the whole population at risk.
As many as 90 percent of all IDUs in Bangladesh share needles and syringes, and according to a comprehensive study by UNICEF and National AIDS/STD Programme (NASP), only 8 percent of all IDUs had full knowledge about transmission and prevention of HIV/AIDS. It is no surprise then that the rate of HIV infection is increasing at an alarming rate among IDUs in Bangladesh.
Street children are particularly vulnerable because they lack education and can be easily exploited — sexually and otherwise. An overwhelming majority of them use drugs and are forced into illegal activities such as drug peddling.
Adolescent girls are four times more likely to contract HIV/AIDS than boys due to sexual violence and exploitation, early sexual initiation and inability to demand safe sex. They often do not have access to education, opportunities and contraceptives and do not have the bargaining power, whether in marriages or outside of it, to exert their reproductive and health rights.
Underage commercial sex workers are in high demand in Bangladesh, and many young girls are forced to it their bodies as the only means of their survival. Although studies suggest that female sex workers are aware of the importance of contraceptives in preventing unwanted pregnancies and sexually-transmitted diseases, oftentimes they cannot dictate to their clients the need to use condoms. The men who engage with them not only put the health of these women in danger but also that of their wives or other partners.
National surveys and international studies highlight that there is an extreme lack of knowledge about HIV/AIDS and sexual and reproductive rights among adolescents. In a country where sex is rarely talked about in public, especially premarital or extramarital sex, adolescents do not have proper or adequate scope to make informed decisions.
Dr Oyewale believes that we need to make information and services available to all young people, irrespective of their gender, class and location, if we want to address the risk of an HIV/AIDS epidemic. “In Bangladesh, only 17 percent of young people have comprehensive knowledge of HIV. We can conduct sex education and awareness programmes that are appropriate for the culture, religion and age group,” he says, adding that it is better for adolescents to have full knowledge and take safety precautions than for us to pretend that risky behaviours do not take place in Bangladesh.
It is also crucial that testing facilities are easily accessible so that any adolescent can walk into them and ask for tests or treatments without fear or shame.
In addition to mass awareness programmes, we also need to address the root causes that make particular groups, like poor youth and girls, especially vulnerable. The government should expand social services and enable easy access to child protection and other schemes, argues Dr Oyewale.