HIV/Aids related risk practices among the users of selected drop-in-centers of Dhaka: A cultural study

Abstract

A Drop-In-Center (DIC) is one of the interventions for HIV/AIDS prevention in Bangladesh where various necessary services are provided to high-risk groups. The purpose of this study was to assess the HIV/AIDS related risk practices among the DIC users, such as, FSWs, IDUs, MSWs and TGs of selected Drop-in-Centers in the Dhaka City. In the study, a total of 416 FSWs, IDUs, MSWs and TGs were taken as sample from 16 DICs by following a simple random sampling technique. Surveys, Case Studies and FGDs were conducted to collect required data from the study participants. The result of the study demonstrated that the majority (70 percent), as observed among the FSWs and their clients, used condoms while having sex to avoid infection of STDIs/STDs and HIV; whereas, almost all (99 percent) of the FSWs reported that they knew how to conduct safe sexual intercourse with their customers. Surprisingly, about 23 percent of the FSWs confessed that they had female condoms while having sex with their clients; and vaginal sex was the most performed form of sex as stated by 84 percent of the FSWs. The findings of the study also pointed out that an overwhelming majority of the IDUs (98 percent) used drugs daily. Similarly, 98 percent of the IDUs reported that they used needle syringe to inject drug into their bodies. Not only they injected drugs, but 66 percent of them also shared needles and syringes with other users. On the contrary, about 28 percent of the MSWs said that they had intercourse with various customers. Shockingly, around one-third of them (27 percent) confessed that they used condoms while having sex. Moreover, just half of the TGs said that they used drugs 3 to 5 days in a week. The results on their sexual behavior proved that 98.60 percent of the TGs had sex with other general clients, TGs, MSWs and FSWs; and 83 percent of them reported that they used condoms with their partners. This study told that DICs provide various necessary facilities, such as, treatment, condoms, lubricants, sleeping place, medical checkup, blood test, counseling facilities, etc. for FSWs, IDUs, MSWs and TGs. The qualitative findings were supported by the quantitative findings of this study. In this study, except male and female SWs, all other risk practicing groups were seem somewhat as self-efficacious in dealing with their sexual partners. FSWs and MSWs were less interested to follow safe practices due to some socio-cultural and economic reasons. Similarly IDUs were more interested to share needles with other users. So, any development or health programs, for high risk population of Bangladesh needs to address several extraneous factors and other local socio-cultural discourses, such as, power relationships, gender, stigma, discrimination, labelling, construction of sexuality, etc, in eradicating any sorts of risk practices related to emerging and re-emerging contagious diseases in a less resourced setting.