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    Posted June 18, 2014 by
    Dhaka, Bangladesh
    This iReport is part of an assignment:
    Living with a rare disease?

    Priority to disarm stigma and discrimination surrounding HIV


    A young woman fidgets, her eyes nervously surveying the dimly lit room, as she prepares to tell the story of how she came to be HIV positive. Sumi* was married at a young age to a construction worker from Chittagong. She moved there to live with him, and was soon pregnant with their first child. However, not long after the birth, her husband was offered a lucrative job in Saudi Arabia. “It was too good an opportunity to pass up”, she recalls, “even though it meant that I was very lonely”. Her husband would visit her once or twice a year, but always sent money back to care for the family. “He was a good man, a good husband” Sumi says of him. However, a few years ago he became sick and was forced to return to Bangladesh. Sumi had two more children, but her husband’s health continued to deteriorate.

    It was only when her husband passed away that Sumi heard of AIDS. “I was shocked” she said, pausing to push damp strands of hair away from her tear streaked face. It was only then that Sumi visited a Drop-In-Centre and learnt that she was HIV positive. Sumi now receives Anti-Retroviral Therapy (ART) to maintain her health, and she is able to work and take care of her children. However, it has not been easy, and stigma and discrimination has made it difficult for her to live a normal life. “Somehow the School learnt that I was HIV positive, and kicked my children out on the street,” she said, gesturing towards the dust filled streets only meters away, “we’ve moved twice since then.”

    Unfortunately, stories like Sumi’s are not uncommon. Stigma and discrimination are major challenges to Save the Children’s “Expanding HIV/AIDS Prevention in Bangladesh” programme, which is funded by The Global Fund to Fight AIDS, Tuberculosis and Malaria. Save the Children works with 23 implementing partners and sub-recipients to provide services those people who are vulnerable to HIV, including people who engage in high risk activities such as sex work and injecting drug use, and people who are living with HIV.

    In addition, media activities such as the popular ‘Banchte Holey Jante Hobey’ (‘Learn to Live’) public awareness campaign aim to build an understanding of HIV in the general population. Other behaviour change communications target young people of reproductive age, garment industry workers and schools.

    One of the keys to success is community engagement; school teachers, religious leaders and countless others have been involved, which helps to remove the taboos associated with HIV, and encourage discussion about prevention, testing and treatment. However, the program still has a long way to go.

    Bangladesh is one of just 4 countries in the Asia Pacific Region where the HIV infection rate has increased by over 25% between 2001 and 2012. According to new data, 30% of newly reported HIV infections are associated with returning migrants, and currently there are no interventions to address this. This is significant because between 2008 and 2012 Bangladesh had a (reported) net migration average of over 2 million, which is why stories such as Sumi’s are increasing. Men and women who travel to other countries engage in high risk activities such as unprotected sex, and then return to their families and spread the infection.

    Once infected, a person living with HIV may not experience symptoms for years, making it difficult to detect. HIV affects the body’s immune system by attacking the white blood cells, eventually making a person living with HIV vulnerable to everyday germs or diseases. However, if a person living with HIV gets tested, then he/she can access ART treatment for free. A person living with HIV can live a perfectly healthy, productive life on ART, but we must increase the number of people being tested so that we can save lives, and stop the spread of HIV. Refocused HIV prevention efforts to disarm the stigma and discrimination surrounding HIV, and to provide services and support for migrant workers, must be a priority to ensure that an AIDS-free Bangladesh remains within reach.

    When asked about the future, Sumi falls silent for several moments. “I don’t know what will happen to me,” she says “but I hope that this doesn’t happen to other people.” Having lost her bread-winning husband and having to hide her status as a HIV positive person, Sumi is in a precarious position, but she is determined to provide everything what her children need. As the afternoon grows cooler the interview comes to a close. Sumi gathers herself swiftly, rearranges her orna, and begins her journey home via the chaotic Chittagong streets, and is soon gone.

    *Names and details of this story have been altered to protect the identity of the persons interviewed.


    Written by Faizul Karim and edited by Dr. Simon Rasin

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