Sharing of Needles and Syringes among Men Who Inject Drugs: HIV Risk in Northwest Bangladesh.

INTRODUCTION:Injection drug use is prevalent in northwestern Bangladesh. We sought to explore the context of needle/syringe sharing among persons who inject drugs (PWID), examining risk exposures to blood-borne infections like the human immunodeficiency virus (HIV) and hepatitis in a region where these dual epidemics are likely to expand. METHODS:We used a qualitative research approach to learn about injection practices, conducting 60 in-depth interviews among PWID. We then conducted 12 focus group discussions (FGDs) that generated a checklist of salient issues, and followed up with personal observations of typical days at the drug-use venues. Content and interpretative frameworks were used to analyze qualitative information and socio-demographic information, using SPSS software. RESULTS:We found that needle/syringe-sharing behaviours were integrated into the overall social and cultural lives of drug users. Sharing behaviours were an central component of PWID social organization. Sharing was perceived as an inherent element within reciprocal relationships, and sharing was tied to beliefs about drug effects, economic adversity, and harassment due to their drug user status. Carrying used needles/syringes to drug-use venues was deemed essential since user-unfriendly needle-syringe distribution schedules of harm reduction programmes made it difficult to access clean needles/syringes in off-hours. PWID had low self-esteem. Unequal power relationships were reported between the field workers of harm reduction programmes and PWID. Field workers expressed anti-PWID bias and judgmental attitudes, and also had had misconceptions about HIV and hepatitis transmission. PWID were especially disturbed that no assistance was forthcoming from risk reduction programme staff when drug users manifested withdrawal symptoms. CONCLUSION:Interventions must take social context into account when scaling up programmes in diverse settings. The social organization of PWID include values that foster needle-syringe sharing. Utilization and impact of risk reduction programmes might be improved with expanded clean needle/syringe distribution at times and venues convenient for PWID, better trained and non-judgmental staff, and medical assistance for health problems, including drug withdrawal symptoms

Socio-demographic profile for 140 persons who inject drugs in Rajshani, Bangladesh.

<p>Socio-demographic profile for 140 persons who inject drugs in Rajshani, Bangladesh.</p

Impact of Community-led Action Research on Production Decisions and Food Adjustment Strategies in a Grain-Producing Village in Northwest Bangladesh

The purpose of the paper is to describe the impact of community-led action research on food security and poverty alleviation on the production decisions and food adjustment strategies of farmers in a grain-producing village in northwest Bangladesh. The study used a mixed method approach with 80 respondents for the quantitative part (survey), which are distributed equally between gono-gobeshona participants and non-participant groups, and 30 for the qualitative part (10 in-depth interviews, 4 key informant interviews, 4 focus groups, and 10 case studies). Survey responses were analyzed using SPSS software and content analysis framework was used for qualitative data. The findings show that far more households who participated in the from the gono-gobeshona make joint decisions (by both husband and wife) in various aspects of production than non-participants. Women as authority figures were higher in number among the participants than the non-participants and more households in the non-participant group considered the husband as the authority figure. Finally, the community-led action research process met sustainability features and was inclusive across social positions

Infrastructure alone cannot ensure resilience to weather events in drinking water supplies

Climate resilient water supplies are those that provide access to drinking water that is sustained through seasons and through extreme events, and where good water quality is also sustained. While surface and groundwater quality are widely understood to vary with rainfall, there is a gap in the evidence on the impact of weather and extremes in rainfall and temperature on drinking water quality, and the role of changes in water system management. A three-country (Bangladesh, Nepal and Tanzania) observational field study tracked 2353 households clustered around 685 water sources across seven different geographies over 14 months. Water quality (E. coli) data was modelled using GEE to account for clustering effects and repeated measures at households. All types of infrastructure were vulnerable to changes in weather, with differences varying between geographies; protected boreholes provided the greatest protection at the point of collection (PoC). Water quality at the point of use (PoU) was vulnerable to changes in weather, through changes in PoC water quality as well as changes in management behaviours, such as safe storage, treatment and cleaning. This is the first study to demonstrate the impact of rainfall and temperature extremes on water quality at the PoC, and the role that weather has on PoU water quality via management behaviours. Climate resilience for water supplies needs to consider the infrastructure as well as the management decisions that are taking place at a community and household level