Bangladesh: empowering women to deal with drug use, HIV and AIDS in their families

In Bangladesh, drug use, especially by injection, is one of the key contributors to the spread of HIV. In 2008, 11.1 per cent of all reported HIV infections were associated with injecting drug use. Unprotected sex is another factor leading to the spread of sexually transmitted infections, including HIV. High rates of illiteracy among women make it more difficult for them to know about the risks of HIV infection and possible protection strategies. Educating women about HIV and AIDS and about sexual and reproductive health, therefore, is essential for their own safety.

In addition, as a result of persistent discrimination, many women continue to be denied the power to negotiate certain situations that would allow them to reduce the risk of becoming infected with HIV. Women who use illicit drugs suffer even more because of the intensity of stigma and discrimination often associated with such drug use. Women are also disproportionately affected by domestic violence, rape and other forms of physical abuse, as well as from a lower social status, more limited educational opportunities and even from crimes such as human trafficking. In general, women present a relatively small segment of drug users, but their situation is of particular concern. The stigma and discrimination they face is disproportionately intense and keeps them from seeking and accessing the health and educational services they need.

Where services are available, too few specifically meet the needs of women, who are then left without concrete options to protect themselves. To respond to this grave situation, UNODC, in partnership with the Government of Bangladesh and civil society partners, implements a model comprehensive package for women who use drugs and women who regularly have sex with men who use drugs. The package includes accessible, non-judgmental, friendly and gender-sensitive services provided by mainly female staff to the women. Further, the interventions are tailored towards outreach, information dissemination, education and primary health-care services that meet women's specific needs.

The story of Asma*, who has been using these services, captures and highlights some of the efforts supported by UNODC and the impact those efforts are having on female drug users in Bangladesh.
"My name is Asma and I am the wife of a drug user. When I got married three years ago, my husband's drug habit was kept a secret by his relatives and closely guarded from me. I have seen my husband use heroin for six long years. As his craving for drugs gradually grew, so did violence at home. He would extort the little money I would save for the house and if I resisted, he would beat me. During those years, the trauma of discrimination that we faced was more painful than the beatings and effects of drug use. The neighbours alienated us and stopped all interaction. I felt helpless, alone and had no idea where to go for help. I needed to share my problems and receive the right advice.

"A few months ago, I learned about the drop-in centre supported by UNODC and its treatment facilities for drug users through an outreach worker. She informed me that many women in a similar situation like me went to the centre for help. Like those women, I started frequenting the drop-in centre, where I learned about the risks of becoming infected with HIV and other sexually transmitted diseases, about how I could get jaundice and about protection strategies. I also received counselling, free medication and treatment from well-trained female doctors after I contracted an infection. Apart from this, I learned how to read and write my name. Today, I help in spreading these prevention messages among other women in the area where I am living. Through all the women's social groups and networks that I have come in contact with through the drop-in centre, I motivate other women not only to educate themselves about health issues, but to claim their social and economic rights as well.

"Visiting the centre has been instrumental in getting my life back and reversing the social attitude that women should not be educated about health issues mainly relating to sexually transmitted diseases. Sharing my problems with female doctors and other women has helped me feel more motivated and accepted. Today, I motivate and support my husband to seek treatment and counselling. I also participate in making decisions that relate to the household, which is a significant step for me. I have realized that social attitudes towards women can change for the better if women themselves become the catalysts for change but not without the support of such interventions."

In Bangladesh, UNODC supports the national response to HIV and AIDS through its project entitled "Prevention of transmission of HIV among drug users in SAARC countries", which has been made possible thanks to the contributions of the Australian Agency for International Development.

*Name has been changed to protect privacy.