Situation Analysis: AIDS is a global problem and it is also a development crisis. In Bangladesh 386 HIV positive cases have been detected so far. Out of them 57 AIDS cases were detected of whom 30 have already died. The situation in Bangladesh is characterized by low prevalence but high risk of HIV, high prevalence of STI, unsafe sex practice and low level of awareness among general mass. Lessons learned from other affected countries advise that early action is essential to stop the spread of HIV from high-risk behaviour group to other groups and society at large. Service integration and partnership with other organizations would be essential and most cost effective option for a country like ours with limited resources to stop the virus from spread, before the economic burden becomes too large to endure.

Problem Analysis:

• Prevention is critical
• Low level of awareness still prevails in Bangladesh. It is difficult to generate awareness about the risk associated with HIV transmission due to conservative social environment that restrict free and open discussion of sexual issues, to reach more vulnerable group is made difficult by the atmosphere of stigma, denial and discrimination.
• National behavioural surveillance found that large number of men continued to buy sex at higher percent than anywhere else in Asia. Majority of men still do not use condoms in commercial sex encounters and female sex workers reported the lowest condom usage in the region which is around 4%. Evaluation study of FPAB also found that consistent condom use among the CSW is 8%.
• The fourth round of serological surveillance has detected 4% HIV infection among high-risk behaviour group in Bangladesh just short of the 5% mark of a concentrated epidemic. The syphilis rate is also high; studies reveal that among female sex workers the rate is as high as 40%.
• Studies also found that increasing trend of premarital and extramarital sexual behaviour also exist in Bangladesh. Poor Access to quality STI/HIV/AIDS related services
• The 1999 to 2000 BDHS found that only 33% married women and 50% married men have knowledge on prevention of HIV-AIDS. Very high numbers of respondents from different groups in the third surveillance are not knowledgeable about the basic modes of HIV transmission, which is 93-97%.
• Study found that service-seeking behaviour related to RTI/STI/HIV/AIDS is not satisfactory. It is also found that some service providers still have negative attitude towards STI/HIV/AIDS, which hinders in providing quality STIs/HIV/AIDS related services and the dual role of condom is not well discussed in the counselling sessions.
• Women status in family, community and society at large is not satisfactory and majority of women are not empowered in decision-making.
• Integration of gender sensitive STIs/HIV-AIDS related preventive services with other projects of FPAB and partnership among different organizations working in the field of HIV-AIDS is still inadequate. Goal Reduction in the incidence of HIV-AIDS and protection of the rights of people infected and affected by HIV-AIDS in Bangladesh.

Strategic Direction: By creating an enabling environment for reducing vulnerability to HIV-AIDS and integrating gender sensitive STI/HIV/AIDS information and clinical services in the existing project activities of FPAB.

Objectives:

• To strengthen support of 50% of the different stake holders in project areas of 7 branches of FPAB in reducing social, religious, cultural barriers that make people vulnerable to HIV-AIDS within 5 years.
• To increase access of beneficiaries to information and clinical services for the prevention and control of STIs/HIV-AIDS by 25% through integrated gender sensitive STI/HIV/AIDS program in the selected project areas by the year 2009.

Activities: (Objective 1)

• Conduct situational assessment studies on existing socio-cultural and religious barriers to HIV-AIDS prevention and use information for designing project activities.
• Conduct workshop for policy level volunteers for sensitisation and to get support from them in the prevention programme of STI/HIV/AIDS.
• Develop, distribute and display need based BCC materials including pictorial leaflet, bill board, organise folk song and street drama and telecast TV serials to reduce stigma associated with HIV/AIDS.
• Organize advocacy seminar with youth/ women organizers and religious /teachers and community influential leaders in order to overcome barriers and ensuring support from them in reducing barriers related to STI/HIV/AIDS.
• Organise orientation for school, college and madrasa teachers on Gender and STI/HIV/AIDS to teach the subject in respective institutions.
• Organise round table meetings with different bodies /committees of government, development partners, NGOs/CBOs working in the field of SRH, HIV/AIDS to get their support.
• Conduct post intervention survey to assess reduction of barriers to HIV/AIDS prevention programme.

Activities: (Objective 2)

• Conduct baseline survey with clients visiting 7 SDPs to assess the STI/HIV/AIDS related information and service seeking behaviour of beneficiaries.
• Review, update and develop modules, manuals and curriculum on gender and HIV/AIDS for clinical and community level service providers.
• Conduct training for clinical and community level service providers of FPAB and other NGOs on Gender and STI/HIV/AIDS.
• Conduct group and individual counselling session at community and clinic level to increase knowledge among beneficiaries on gender and STI/HIV/AIDS and empower them to be able to protect themselves.
• Provide quality gender friendly STI/HIV/AIDS services, promote condom and introduce VCT for increasing availability through static and mobile clinics.
• Establish proper referral services with government and other clinics for PLWA.
• Conduct post intervention survey to measure STD/HIV/AIDS related service seeking behaviour of men and women in project areas
• Document lessons learnt and disseminate the same among development partners, Government, NGOs and community.

Outcomes and Indicators: