HIV/AIDS today over the passage of time becomes one of the deadly diseases ever faced by mankind and the most devastating pandemic in human history. AIDS already has claimed the lives of more than 23 million people, killing more than 3 million every year. According to WHO report 2002, an estimated 42 million people throughout the globe currently is living with HIV. Another 70 million men, women and children may die of AIDS in the next 20 years. It is not only a big problem to the public health but also a big threat to development.

Although Bangladesh continues to be a low prevalence (less than 1%) area, it is surrounded by high prevalence countries (High prevalence of HIV/AIDS in neighboring India). Our country has all the determinants for an explosive outbreak of HIV/AIDS epidemic. Curses of poverty, illiteracy, ignorance, proximity of Bangladesh to the so-called 'Golden Triangle' & high prevalence of STDs, make our country seriously vulnerable. The emergence of a generalized HIV epidemic would be a disaster that poverty-stricken Bangladesh could ill-afford. It is estimated that without any intervention the prevalence in the general adult population could be as high as 2% in 2012 and 8% by 2025. Bangladesh initiated an early response to the HIV epidemic starting in the mid-1980s. Since then, the response has been enhanced considerably, and many HIV-prevention interventions among the most at-risk populations and the general youth are being undertaken. Injecting drug users, sex workers and men having sex with men are considered most at-risk groups to HIV infection in Bangladesh. To complement the efforts of the Bangladesh Government, a large number of NGOs are actively working on HIV and AIDS.

Padakhep, as an NGO has been intervening in the field since 1998 and has expanded its HIV/AIDS prevention activities in different districts of Bangladesh.

Objective:
Major objectives of the HIV/AIDS prevention program of Padakhep are to:

• Limit the spread of HIV and AIDS among people using drugs     intravenously.
• Reduce the vulnerability of HIV/AIDS among the sex workers.

In Bangladesh, the intravenous drug users (IDU) are the most potential carriers of HIV/AIDS among the vulnerable groups in the country. The fourth round of national HIV and behavioral surveillance report showed that the HIV infection rate among the IDUs is now 4%, up from 2.5% previously which is just short of the 5% mark of a concentrated epidemic. About 93.4% IDUs in central Bangladesh admitted that they share same syringes while taking drugs. Even they use the same syringe several times for taking drug which is one of the most effective ways of spreading an HIV/AIDS epidemic. To prevent a future HIV epidemic among the drug users and to reduce the harmful implications of drug use, Padakhep provided some services to the IDUs. Major services are needle syringe exchange, condom promotion, STD/abscess/general health support, counseling, awareness through health education, referral services and advocacy with the community leaders. Commercial female sex workers are also considered as the vulnerable groups for the spread of HIV/AIDS in Bangladesh. With a view to reducing the vulnerability of HIV/AIDS among the sex workers, Padakhep provided services to the female sex workers. Regular services like health, education, STI management and general health services, condom promotion, counseling were provided. Padakhep also took necessary initiative for capacity building of the sex workers for involving them in alternative income generating activities based on demands.

With the goal to reduce HIV transmission among most-at-risk population, Padakhep formed new CBOs (Community-based organizations) and strengthened the capacity of the existing CBOs. The CBOs comprised injecting drug users (IDUs), female sex workers (FSWs) and males having sex with males (MSMs). Padakhep provided support for developing good governance and management practices of CBOs.

Padakhep organized national, district and local level advocacy workshops/meetings with the law enforcement agencies, policy makers, civil society and local people to improve their knowledge on HIV/AIDS. As a result, they became aware about their responsibilities that are playing a role to prevent the epidemic of HIV/AIDS. Besides, different training programs, workshops and seminars are gradually helping the CBOs comprising IDUs, FSW, MSM and TG to improve their capacity building.

Padakhep provided the services mentioned above to limit the spread of HIV/AIDS among the IDUs and reduce vulnerability of sex workers to HIV/AIDS.