Assessment of the Utilization of HIV Interventions by Sex Workers in Selected Brothels in Bangladesh: An Exploratory Study

In this qualitative study of brothel-based Female Sex Workers (FSWs), the authors explored factors that influence safe sex practices of FSWs within an integrated HIV intervention. Qualitative methods, including focus group discussions (FGDs), in-depth interviews and key informant interviews were applied in four brothels in Bangladesh. Young and elderly FSWs, Sordarnis (Madams who own young FSWs and who may be either active or inactive sex workers themselves), program managers and providers were the participants for this study. Findings showed that condom use was high but not consistent among bonded FSWs (those who are under the control of a Sordarni) who have regular clients. The bonded FSWs reported being maltreated by the Sordarnis for refusing to have sex without a condom, and access to health services was hindered by Sordarnis. Implications of the study are that integrated HIV intervention should provide more encouragement to relevant stakeholders to promote mutual support towards safe sex practices for the FSWs

HIV and AIDS in Bangladesh

Bangladesh initiated an early response to the HIV epidemic starting in the mid-1980s. Since then, the res-ponse has been enhanced considerably, and many HIV-prevention interventions among the most at-risk populations and the general youth are being undertaken. Alongside prevention activities, gathering of data has been a key activity fostered by both the Government and individual development partners. This paper reviews available sources of data, including routine surveillance (HIV and behavioural among most at-risk populations), general population surveys, and various research studies with the aim to understand the dynamics of the HIV epidemic in Bangladesh. Available data show that the HIV epidemic is still at relatively low levels and is concentrated mainly among injecting drug users (IDUs) in Dhaka city. In addition, when the passively-reported cases were analyzed, another population group that appears to be especially vulnerable is migrant workers who leave their families and travel abroad for work. However, all sources of data confirm that risk behaviours that make individuals vulnerable to HIV are high—this is apparent within most at-risk populations and the general population (adult males and youth males and females). Based on the current activities and the sources of data, modelling exercises of the future of the HIV epidemic in Dhaka suggest that, if interventions are not enhanced further, Bangladesh is likely to start with an IDU-driven epidemic, similar to other neighbouring countries, which will then move to other population groups, including sex workers, males who have sex with males, clients of sex workers, and ultimately their families. This review reiterates the often repeated message that if Bangladesh wants to be an example of how to avert an HIV epidemic, it needs to act now using evidence-based programming

HIV and AIDS in Bangladesh

Bangladesh initiated an early response to the HIV epidemic starting in the mid-1980s. Since then, the res-ponse has been enhanced considerably, and many HIV-prevention interventions among the most at-risk populations and the general youth are being undertaken. Alongside prevention activities, gathering of data has been a key activity fostered by both the Government and individual development partners. This paper reviews available sources of data, including routine surveillance (HIV and behavioural among most at-risk populations), general population surveys, and various research studies with the aim to understand the dynamics of the HIV epidemic in Bangladesh. Available data show that the HIV epidemic is still at relatively low levels and is concentrated mainly among injecting drug users (IDUs) in Dhaka city. In addition, when the passively-reported cases were analyzed, another population group that appears to be especially vulnerable is migrant workers who leave their families and travel abroad for work. However, all sources of data confirm that risk behaviours that make individuals vulnerable to HIV are high-this is apparent within most at-risk populations and the general population (adult males and youth males and females). Based on the current activities and the sources of data, modelling exercises of the future of the HIV epidemic in Dhaka suggest that, if interventions are not enhanced further, Bangladesh is likely to start with an IDU-driven epidemic, similar to other neighbouring countries, which will then move to other population groups, including sex workers, males who have sex with males, clients of sex workers, and ultimately their families. This review reiterates the often repeated message that if Bangladesh wants to be an example of how to avert an HIV epidemic, it needs to act now using evidence-based programming

Optimization of H₂ Supply to the Refuelling Infrastructure for Long-Haul Trucks: Centralized versus Local H₂ Production, and Using Transportation by Tanker Truck or Pipeline

In a simulation study, it was investigated how the costs of supplying H2 for the refuelling of long-haul trucks along highways in Canada can be minimized by optimizing the design of the refuelling infrastructure. Scenarios using local or centralized blue H2 production were evaluated using two different modes of H2 transportation (liquid H2 tanker trucks and pipelines). For each scenario, the average H2 supply costs were determined considering H2 production costs from facilities of different sizes and transportation costs for H2 that was not produced locally. Average H2 supply costs were 2.83 CAD/kg H2 for the scenario with local H2 production at each refuelling site, 3.22–3.27 CAD/kg H2 for scenarios using centralized H2 production and tanker truck transportation, and 2.92–2.96 CAD/kg H2 for centralized H2 production scenarios with pipeline transportation. Optimized scenarios using the cheaper transportation option (tanker truck or pipeline) for each highway segment had average H2 supply costs (2.82–2.88 CAD/kg H2) similar to those of using only local H2 production, with slightly lower costs for the scenario using the largest H2 production volumes. Follow-on research is recommended to include the impact of CO2 transportation (from blue H2 production) on the design of an optimum supply infrastructure

Can 1- and 2-year-old toddlers learn causal action sequences?

Toddlers can learn cause-effect relationships between single actions and outcomes. However, real-world causality is often more complex. We investigated whether toddlers (12- to 35-month-olds) can learn that a sequence of two actions is causally necessary, from observing the actions of an adult demonstrator. In Experiment 1, toddlers saw evidence that performing a two-action sequence (AB) on a puzzle-box was necessary to produce a sticker, and evidence that B alone was not sufficient. Toddlers were then given the opportunity to interact with the box and retrieve up to five stickers. Toddlers had difficulty reproducing the required two-action sequence, with the ability to do so improving with age. In Experiment 2, toddlers saw evidence that performing a single action (B) was sufficient to produce an effect (i.e., a sequence was not causally necessary). Toddlers were more successful and performed fewer sequences in Experiment 2, suggesting some sensitivity to the sequential causal structure

Can 1- and 2-year-old toddlers learn causal action sequences?

Toddlers can learn cause-effect relationships between single actions and outcomes. However, real-world causality is often more complex. We investigated whether toddlers (12- to 35-month-olds) can learn that a sequence of two actions is causally necessary, from observing the actions of an adult demonstrator. In Experiment 1, toddlers saw evidence that performing a two-action sequence (AB) on a puzzle-box was necessary to produce a sticker, and evidence that B alone was not sufficient. Toddlers were then given the opportunity to interact with the box and retrieve up to five stickers. Toddlers had difficulty reproducing the required two-action sequence, with the ability to do so improving with age. In Experiment 2, toddlers saw evidence that performing a single action (B) was sufficient to produce an effect (i.e., a sequence was not causally necessary). Toddlers were more successful and performed fewer sequences in Experiment 2, suggesting some sensitivity to the sequential causal structure