Islam M Mofizul, Conigrave Katherine M
Faculty of Medicine, The University of Sydney, Australia.
Drug Alcohol Rev. 2007 Jul;26(4):445-54. doi: 10.1080/09595230701373925.
The aim of this study was to examine trends in HIV and related risk behaviours in drug users in Bangladesh, the effects of prevention and harm reduction initiatives that have already been undertaken and to highlight immediate needs.
Journal publications, conference abstracts and proceedings were collected and reviewed. As there were relatively few published papers, the grey literature was also reviewed. Experts involved in the development and evaluation of current programmes or policy were contacted for official reports, policy documents or unpublished materials. The trends in injecting and sexual risk behaviours were tabulated.
Periodic behavioural and serosurveillance on recognised sentinel groups shows clearly that HIV prevalence among injecting drug users has been increasing steadily. In the capital city, the HIV prevalence among injecting drug users is close to the level of a concentrated epidemic (4.9%). While harm reduction strategies have brought a scope of reduction of injecting-related risk behaviours, the persistent high rates of needle sharing and high prevalence of sexual risk behaviours remains alarming. Non-injecting drug users have maintained a low prevalence of HIV but their high-risk sexual behaviours and transformation into injecting drug users with time are of concern.
There are substantial gaps between current needs and the ongoing prevention and harm reduction activities. There is a pressing need for a comprehensive harm reduction programme and review of any policies and laws which may impede this.
本研究旨在调查孟加拉国吸毒者中艾滋病毒及相关风险行为的趋势、已开展的预防和减少伤害举措的效果，并突出当前的迫切需求。
收集并审查了期刊出版物、会议摘要和会议记录。由于已发表的论文相对较少，还审查了灰色文献。联系了参与当前项目或政策制定与评估的专家，获取官方报告、政策文件或未发表的材料。将注射和性风险行为的趋势制成表格。
对公认的哨点人群进行的定期行为和血清学监测清楚地表明，注射吸毒者中的艾滋病毒流行率一直在稳步上升。在首都，注射吸毒者中的艾滋病毒流行率接近集中流行水平（4.9%）。虽然减少伤害策略已在一定程度上降低了与注射相关的风险行为，但共用针头的持续高比例和性风险行为的高流行率仍然令人担忧。非注射吸毒者的艾滋病毒流行率一直较低，但他们的高风险性行为以及随着时间推移转变为注射吸毒者的情况令人担忧。
当前需求与正在进行的预防和减少伤害活动之间存在巨大差距。迫切需要一项全面的减少伤害计划，并审查可能阻碍该计划的任何政策和法律。
