At a glance: HIV in Bangladesh

• 15,000 people with HIV
• <0.1% adult HIV prevalence
• 1,100 new HIV infections
• <500 AIDS-related deaths
• 31% people on antiretroviral treatment

The current targets for HIV testing and treatment are called the 95-95-95 targets and must be reached by 2025 in order to end AIDS by 2030.

Some data about the HIV epidemic in Bangladesh is missing, including that on the percentage of people on treatment having suppressed viral loads.

In 2021 in Bangladesh:

Did you know?

Although Bangladesh has low HIV prevalence, it is one of seven countries in the Asia and the Pacific region where new infections are increasing.

Preventing HIV in Bangladesh focuses on:

• prevention of mother-to-child transmission
• harm reduction
• condom and lubricant distribution
• PrEP (in pilot stage)
• reducing violence against sex workers
• integrating HIV prevention into sexual and reproductive health services.

Did you know?  

Despite efforts to distribute condoms, the percentage of people from the most at risk groups using them is relatively low – 74% of sex workers, 53% of men who have sex with men, 49% of people who inject drugs, and 40% of transgender people (sometimes referred to as ‘hijra’) used a condom the last time they had sex.

Testing for HIV is:

• provided as part of antenatal care
• provided by non-governmental organisations and community-based organisations
• offered separately from HIV counselling services.

Did you know?

It is estimated that around half of men in Bangladesh who have sex with men are also married to women. But no specialist testing programmes exist for these couples or for women in relationships with men who have sex with men.

Treatment for HIV is:

• available in a limited number of health facilities, for adults and children
• dependent on CD4 count
• not covered by annual health insurance, so can be expensive
• not offered alongside viral load monitoring
• available alongside adherence support (in some facilities).

Did you know?

Many people with HIV are reluctant to access HIV treatment because of the way they are likely to be treated by healthcare staff: research suggests around 80% of nurses and 90% of doctors have discriminatory attitudes towards people with HIV.

Because HIV prevalence among the general population in Bangladesh is low, the HIV epidemic has not been viewed as a priority. But in recent years, HIV infections in Bangladesh have been rising, driven by poverty, injecting drug use, gender inequality, gender-based violence, migration, a highly mobile population and high levels of transactional sex. The fact that only 31% of people with HIV are on treatment also fuels transmission.

Until recently, there has been a lack of HIV data in Bangladesh. This makes it hard to get a clear picture of the epidemic and to inform effective programmes. However, it’s clear that a rapid expansion of HIV prevention and treatment services is needed for Bangladesh to begin to reverse its HIV epidemic.

The Bangladeshi Government needs to ensure the limited resources available for HIV are spent more strategically to have the maximum impact. Bangladesh is currently relying on external resources to fund its HIV care facilities and prevention programmes. In 2021/22, the Bangladeshi Government allocated 5% of its total budget on health, a less than 1% increase from the previous year.

The legal environment in Bangladesh stops HIV prevention, testing and treatment services from reaching the groups that most need them. Stigma and discrimination also stops marginalised groups from accessing services. Homosexuality is illegal, punishable by up to 14 years in prison. Sex work and drug use are also criminalised. Abortion is only legal in limited circumstances if the woman’s life is at risk.

There are no education policies to guide the delivery of HIV and sexuality education in primary or secondary school or further education. In 2014, only 13% of adolescent girls and young women in Bangladesh fully knew how to prevent HIV.