Sex workers in Bangladesh most vulnerable to HIV

In Bangladesh, the rate of HIV infections is comparatively lower than the rest of the world, yet it remains a severe threat due to the violence against the ample amount of sex workers in the country.

Lima Rahman and Md Abdul Quayyum from Save the Children recently discussed the social problems that make sex workers in Bangladesh vulnerable to HIV.

Many are deprived of their fundamental sexual and reproductive rights due to the social stigma and marginalization around their profession. This makes them prone to discrimination and victims of physical and sexual assault.

Apart from people who inject drugs, men who have sex with men, male sex workers, transgenders, sex workers are the most vulnerable to HIV infection as it can rapidly spread among their community.

In many cases, sex workers do not have access to condoms, or are not aware of their importance. Clients sometimes refuse to pay for sex if they have to use condoms. They also often use intimidation and violence that can lead to rape. The decriminalization of sex work in the society discourages victims to press charges against their perpetrators, and creates an environment where violence against sex workers is tolerated and considered “normal” or “part of the job”. They do not have information about their rights nor any legal support. They are simply powerless to negotiate safer sex.

According to a recent study, the total estimated number of female sex workers in Bangladesh ranges from 82,884 to 102,260. They are engaged in this trade through brothels, hotels, residences and street-based set-ups. More than half of the female sex workers interviewed reported that they had sex for the first time before the age of 15. Additionally, a majority of them had sexual encounters without the use of condoms. With their identities, they hardly get any basic services from hospitals and mainstream health providers.

HIV prevention policies and programs focusing on sex workers, therefore, must also include violence prevention strategies. Interventions to promote safer sex among sex workers must be part of an overall effort to ensure their safety and human rights.

Save the Children have been operating 43 drop-in-centres for female sex workers since 2008. The centres give psychological support and essential health services to at least 26,000, but there is need for more.

To cut HIV prevalence drastically, empowering sex workers and involving them in HIV prevention is crucial.  They must have better legal protection and a discrimination free environment.

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