Population Council Research that makes a difference

HIV prevalence among most-at-risk populations (MARPs) in Bangladesh is less than 1 percent. However, the rate of HIV infection is as high as 11 percent among injecting drug users in one part of central Bangladesh. The overlapping risk behaviors of MARPs and other risk factors could fuel the spread of HIV from MARPs to the general population. While the number of people identified as HIV-positive in Bangladesh is 1,745 as of December 2009, the estimated number of HIV-positive people is approximately 12,000. Among MARPs that number is approximately 280,000. The care and support needs of these groups have not been properly assessed, and organizations that provide treatment, care, and support are inadequate and are not uniform in the way they provide services because of the absence of national standard operating procedures and tools for improving provider capacity.

The challenges that people living with HIV and AIDS (PLHA) and MARPs face in terms of stigma and discrimination are extreme, and the resulting adversity spreads across family, society, and healthcare providers. Therefore, it is important to create a supportive environment for these vulnerable populations so that they may easily access high-quality HIV prevention, treatment, care, and other support services. 

The Population Council is a member of a consortium of the HIV and AIDS prevention and control program in Bangladesh funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria and led by BRAC University's James P. Grant School of Public Health. The consortium has been implementing a project to improve the ability of organizations to deliver services related to HIV and AIDS to MARPs, PLHA, and other vulnerable populations. The Council is responsible for developing and operationalizing the national standards and tools for providing high-quality services. It also monitors project activities. The project, which began in February 2007 and will end in March 2011, covers 20 districts of six administrative divisions of Bangladesh.

Population Council researchers conducted a needs assessment and developed national standard operating procedures (SOPs) and training manuals on counseling, peer education, care giving, and stigma and discrimination related to HIV and AIDS to strengthen the capacity of organizations delivering services to PLHA and MARPs. The SOPs and training manuals are being implemented in the field with technical assistance from the Council. Council researchers are conducting another needs assessment to develop new tools and guidelines on the basis of identified and prioritized needs of the beneficiaries and organizations working with vulnerable populations.

Project activities also include field-level monitoring of 225 master trainers from 130 NGOs to conduct in-house training, and the training of 160 government and NGO midlevel managers on issues related to HIV and AIDS, management, and monitoring and evaluation. District AIDS committees (DACs) have been formed in ten districts, and the process of DAC formation is underway in another ten districts to coordinate activities at the district level.