Modes of HIV transmissions in Dhaka city

Abstract

Introduction: The epidemic in Dhaka, capital city of Bangladesh, was believed to be driven by injecting drug use as human immunodeficiency virus (HIV) has been concentrated among people who injected drugs since 2006. However, the needle/syringe program coupled with other prevention interventions among the key populations (KPs) and may have limited HIV spread from people who inject drugs (PWID) altering the modes of transmission (MOT). Material and methods: The AIDS Epidemic Model was used to assess probable HIV transmission modes, which used data and information on indicators and co-factors from national behavioral surveys, serological surveillances, and other relevant studies including program data from 2000-2013. Results: The distribution of HIV infections by MOT reveals that in 2000, needle sharing was the major source of HIV infection (48%) in Dhaka, followed by (female) sex work (30%), male-to-male sex (12%), heterosexual relationships (husband to wife, 9%), and other sources (1%). In 2014, needle sharing as a mode of transmission dropped to 28%. In the same year, male-to-male sex accounted for 42% of new HIV infections. It is projected that male-to-male sex will be responsible for 54 percent of new infections by 2020 in Dhaka. Conclusions: The needle/syringe exchange program and other interventions among KPs have shifted the MOT in Dhaka city. Human immunodeficiency virus intervention strategies and coverage in Dhaka should be revised and focused to address the evolving epidemic.