The HIV epidemic in Bangladesh is largely being driven by people who inject drugs (PWID) and mainly concentrated in Dhaka city. Intregrated biological and behavioural survey (IBBS) data of 2016 ...showed that a considerable percentage of the HIV positive PWID had unsafe sex with their female sex partners. Prevalence of HIV, risk behaviorus and vulnerabilities among the female sex partners of the PWID still remain unexplored.
To measure HIV prevalence, risk behaviours (drugs/injection/sexual) and vulnerabilities (treatment of and knowledge of sexually transmitted infections (STIs) and HIV/uptake of the routine HIV testing and HIV prevention services/physical and sexual violence), a quantitative survey was conducted among 227 female sex partners of the HIV positive PWID in Dhaka city in 2019 by adopting a take-all sampling technique.
The median age of participants was 34.0 years. Prevalence of HIV was 16.7% (95% CI: 12.4-22.2). Only 6.8% to 18.7% of the participants used condoms consistently with different male sex partners; only 6.8%cto 18.7% during last year. Seventy five percent (95% CI: 69.2-80.8) had no knowledge on STI symptoms. Self-reported symptoms of STIs were reported by 26% (95% CI: 20.7-32.1) and half sought treatment during last year. Nineteen percent (95% CI: 14.7-25.1) had comprehensive knowledge of HIV. As part of the routine HIV prevention services by the PWID drop-in-centres (DICs), 42.7% (95% CI: 36.4-49.3) of the participants were tested for HIV and knew their result within the last year. One-third never received HIV prevention services. During the last one year preceding the survey, 46% (95% CI: 39.3-52.6) reported been beaten and 20.2% (95% CI: 15.3-26.1) been raped.
It is urgently necessary to consider the high-risk behaviours and vulnerabilities in designing or to strengthen targeted interventions for female sex partners of the HIV positive PWID in Dhaka city to ensure equality in accessing and utilization of services.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Genetic diversity and molecular epidemiology of HIV are directly relevant to HIV transmission. We report here the genetic diversity and transmission dynamics of non-C subtypes of HIV-1 strains ...detected in Bangladeshi key populations. Sequence analysis of gag gene revealed four subtypes A1, B, D, G, and nine CRFs (01_AE, 02_AG, 09_cpx, 10_CD, 15_AE/B, 13_cpx, 14_BG, 22_01_A1, and 25_AGU). Most of these non-C strains were detected in returnee migrant workers from different parts of the world. Phylogenetic analysis showed that the Bangladeshi HIV-1 strains detected in migrant workers and their wives and local sex workers shared common ancestries. The identification of the multiple subtypes indicates high diversity of non-C HIV-1 variants circulating in Bangladesh which might have been imported by migrant workers from multiple geographical areas.
•HIV subtype C and C-related recombinants have remained the major circulating genotypes in Bangladesh, mainly transmitting within PWID.•We report here for the first time the HIV-1 drug resistance ...profile from Bangladesh.•The study findings warrant continuous monitoring of HIV-positive individuals to identify social networks within and between KPs.
HIV-1 subtyping data of Bangladeshi strains are available in global HIV Sequence Database up to 2007, and there is no sequence of drug resistance profile based on the pol gene segment. This study aimed to update HIV genotyping data and describe the drug resistance mutations for the first time from Bangladesh using specimens from the latest HIV sero-surveillance conducted in 2016.
During HIV sero-surveillance, a total of 1268 people who inject drugs (PWID) and 3765 female sex workers (FSW) were screened and among them, 230 (18.1%) PWID and 7 (0.2%) FSW were HIV positive. Among HIV positives, randomly selected 74 specimens (60 male-PWID, 7 female-PWID, and 7 FSW) were subjected to gag, pol, and env gene sequencing using gene-specific primers. Genotyping was decided based on the partial gag and env genes while transmission dynamics was based on the gag sequence (n = 237). Drug resistance profiles were obtained by using the algorithm of the established available drug resistance database.
HIV subtype C and C-related recombinants have remained the major circulating genotypes in Bangladesh. Although the recurring transmission of subtype C occurred among PWID, we identified possible transmission to other key populations (KPs), which suggests spillover from PWID through the sexual route. The prevalence of drug-resistant mutation was low, and all strains were susceptible to NRTIs and NNRTIs drugs. Unique recombination forms (URF) with genotype C for gag–pol and A1 for env was also identified.
The study findings warrant continuous monitoring of HIV-positive individuals and future investigation to identify social networks within and between KPs to halt the transmission and prevent new infections.
Key populations (KPs) who are at risk of compromised situation of sexual and reproductive health and rights in Bangladesh constitute including males having sex with males, male sex workers, ...transgender women (locally known as hijra) and female sex workers. Globally, these key populations experience various sexual and reproductive health and rights burdens and unmet needs for ailments such as sexually transmitted infections including Neisseria Gonorrhoea, Chlamydia Trachomatis and human papillomavirus. Most key population focused interventions around the world, including Bangladesh, primarily address human immune deficiency virus and sexually transmitted infections-related concerns and provide syndromic management of sexually transmitted infections, other sexual and reproductive health and rights issues are remained overlooked that creates a lack of information in the related areas. There is currently no systematic research in Bangladesh that can produce representative data on sexual and reproductive health and rights among key populations, investigates their sexual and reproductive health and rights needs, how their needs evolve, and investigate underlying factors of sexual and reproductive health and rights issues that is crucial for informing more sexual and reproductive health and rights-friendly interventions for key populations. Keeping all these issues in mind, we are proposing to establish a sexual and reproductive health and rights surveillance system for key populations in Bangladesh.
The sexual and reproductive health and rights surveillance system will be established in Dhaka for males having sex with males, male sex workers and transgender women, and the other in Jashore for female sex workers. The duration will be for 3 years and data will be collected twice, in year one and year two adopting a mixed method repeated cross-sectional design. All key populations 15 years and above will be sampled. Behavioural data will be collected adopting a face-to-face technique and then biological samples will be collected. Those who will be found positive for human papillomavirus, will be referred to a government hospital for treatment. Free treatment will be provided to those who will be found positive for other sexually transmitted infections. In total, 2,240 key populations will be sampled. Written assent/consent will be taken from everyone. Data will be entered by Epi-Info and analysed by Stata. Report will be produced in every year.
This surveillance system will be the first of its kind to systematically assess the situation of sexual and reproductive health and rights among selected key populations in Bangladesh. It is expected that this study will provide insights needed for improving the existing sexual and reproductive health and rights intervention modalities for these vulnerable and marginalized key populations.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We examine the financial stability efficiency of Islamic and conventional banks. We employ a meta-frontier stability function approach based on stochastic frontier framework to estimate financial ...stability efficiency of both bank groups, drawing on a sample of Islamic and conventional banks from 28 countries over the period 2003–2018. Our study result shows that Islamic banks have 5.30% higher stability efficiency compared to conventional banks. This result is robust when we examine country-wise and geographical region-wise stability efficiency of Islamic and conventional banks.
•We examine the financial stability efficiency of Islamic and conventional banks using the stochastic meta-frontier stability function.•We find that Islamic banks have 5.30% higher meta-stability efficiency compared to conventional banks.•The result is robust when we examine country-wise and geographical region-wise stability efficiency of Islamic and conventional banks.
This study investigates whether higher educational attainment (i.e., doctorate degrees) of Shariah supervisory board (SSB) members is relevant to funding liquidity in Islamic banks. Using a firm ...fixed effects regression framework with data from 63 Islamic banks in 10 countries, we find that higher educational attainment of SSB members increases funding liquidity. We also show that the result holds when we employ subsample analysis for countries with a national-level Shariah regulatory authority, a systematically important Islamic banking sector, and young and small Islamic banks. Our results remain consistent after employing the alternative estimation techniques of change analysis, propensity score-matching analysis, and instrumental variable approach.
•This research investigates whether higher educational attainment (i.e., doctorate degrees) of Shariah supervisory board (SSB) members matters in funding liquidity in Islamic banks.•We document that the higher educational attainment of SSB members increases funding liquidity.•Our results remain consistent after employing the change analysis, the propensity score-matching analysis, and the instrumental variable approach as alternative estimation techniques.
Previous studies have compared the efficiency of Islamic banks with their conventional counterparts using a common efficiency frontier and ignoring risks, in spite of the two bank groups operating ...under different technological, market and institutional conditions. We overcome this issue by estimating efficiency using the stochastic meta-frontier model for a large international sample, and show that compared to conventional banks, Islamic banks are 4 percentage points more cost efficient, but 17 percentage points less profit efficient on a risk-adjusted basis. For both bank types, higher bank risk reduces cost efficiency but increases profit efficiency, implying that risks contribute more to generating revenues than inflating costs. Having a stronger Shariah supervisory board is conducive to improving Islamic banks' profit efficiency. Our findings are robust to accounting for potential endogeneity in the governance-efficiency relationship.
•Compared to conventional banks, Islamic banks are more cost efficient but less profit efficient on a risk-adjusted basis.•Higher bank risk reduces cost efficiency but increases profit efficiency.•Having a stronger Shariah supervisory board is conducive to improving Islamic banks' profit efficiency.
This study examines the effect of Islamic banks' dual board governance mechanisms (Shariah supervisory board and regular board of directors) on technical efficiency; and whether the effect of such ...governance mechanisms varies between normal times and global financial crisis period. The results show that Shariah supervisory board contributes to reducing an Islamic bank's technical inefficiency. During the GFC, both SSB governance and regular board governance generate an incremental efficiency gain to Islamic banks, but the effect is more pronounced for SSB governance. The key findings on the governance-inefficiency relationship are robust to controlling for potential endogeneity of corporate governance.
•Examine the effect of Shariah supervisory board (SSB) governance on crisis-period efficiency in Islamic banks.•Investigate the effect of regular board governance on crisis-period efficiency in Islamic and conventional banks.•Evaluate the inter-relationship between risk, efficiency and capitalisation in Islamic and conventional banks.
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