The 2015 UN World Drug Report found that global drug use prevalence remains stable but access to treatment is still low. Approximately 246 million people worldwide use illicit drugs like cannabis, cocaine, and amphetamines. Problem drug use disproportionately affects men and injection drug users are at high risk of contracting HIV. While opium cultivation is at its highest level since the 1930s, the UNODC Executive Director called for greater investment in long-term medical treatment for drug dependence as well as alternative development programs to address the social and economic factors driving illicit crop cultivation.

1. Page-1
2015 World Drug Report finds drug use stable,
access to drug & HIV treatment still low
UNODC Chief calls number of drug-related deaths worldwide
unacceptable; Global opium cultivation highest since the late-1930s
Drug use prevalence continues to be stable around the world, according to
the 2015 World Drug Report of the United Nations Office on Drugs and
Crime (UNODC). It is estimated that a total of 246 million people -
slightly over 5 per cent of those aged 15 to 64 years worldwide - used an
illicit drug in 2013. Some 27 million people are problem drug users,
almost half of whom are people who inject drugs (PWID). An estimated
1.65 million of people who inject drugs were living with HIV in 2013.
Men are three times more likely than women to use cannabis, cocaine and
amphetamines, while women are more likely to misuse prescription
opioids and tranquillizers.
Speaking on the International Day against Drug Abuse and Illicit
Trafficking, UNODC Executive Director Yury Fedotov noted that,
although drug use is stable around the world, only one out of six problem
drug users has access to treatment. "Women in particular appear to face
barriers to treatment - while one out of three drug users globally is a
woman, only one out of five drug users in treatment is a woman."
Additionally, Mr Fedotov stated that more work needed to be done to
promote the importance of understanding and addressing drug
dependence as a chronic health condition which, like other chronic
conditions such as diabetes or hypertension, require long-term, sustained
treatment and care. "There is no quick and simple remedy for drug
dependence and we need to invest in long term, medical evidence-based
solutions."
Drug use and its impact on health.
A stable yet still unacceptably high number of drug users worldwide
continue to lose their lives prematurely, the UNODC Chief said, with an
estimated 187,100 drug-related deaths in 2013. The World Drug Report
includes data - gathered jointly with UNAIDS, WHO and the World Bank

2. Page-2
- on HIV prevalence among PWID. In some countries women who inject
drugs are more vulnerable to HIV infection than men and the prevalence
of HIV can be higher among women who inject drugs than among their
male counterparts. The number of new HIV infections among PWID
declined by roughly 10 per cent between 2010 and 2013: from an
estimated 110,000 to 98,000. However, the World Drug Report also
indicates that many risk factors, including the transmission of infectious
diseases such as HIV and Hepatitis C and the incidences of drug
overdoses, cause the death rate among PWID to be 15 times higher than
in the rest of the population.
While data indicate that the use of opiates (heroin and opium) has
remained stable at the global level and cocaine use has declined overall,
the use of cannabis and the non-medical use of pharmaceutical opioids
has continued to rise. Evidence suggests that more drug users are
suffering from cannabis use disorders, and that cannabis may be
becoming more harmful, as reflected in the high proportion of persons
seeking first-time treatment in several regions of the world. Demand for
treatment has also increased for amphetamine-type stimulants (ATS) -
including methamphetamine and MDMA or 'Ecstasy' - and for new
psychoactive substances (NPS), also known as 'legal highs'.
Illegal drug supply and markets Some 32.4 million people - or 0.7 per
cent of the world's adult population - are users of pharmaceutical opioids
and opiates such as heroin and opium. In 2014, global potential opium
production reached 7,554 tons - the second highest level since the 1930s,
mainly due to its cultivation increasing significantly in Afghanistan, the
main growing country. The global seizures of heroin, meanwhile,
increased by eight per cent, while illicit morphine seizures decreased by
26 per cent from 2012 to 2013.
While maritime trafficking is not the most widely used mode of
smuggling drugs, law enforcement operations at sea have potentially the
greatest impact as the average volumes of seizures is proportionally
higher. In the period 2009-2014, for instance, the average for each seizure
by sea was 365kg, while by land (road and rail) it was 107kg and by air
10kg. The 2015 World Drug Report also notes a dynamic shift in the

3. Page-3
routes used for smuggling opiates, with Afghan heroin reaching new
markets. Recent seizures suggest that it may have become more common
for large shipments of Afghan heroin to be smuggled across the Indian
Ocean into East and Southern Africa. West Africa continues to be a trans-
shipment area for smuggling cocaine across the Atlantic into Europe, and
Eastern Europe is emerging as a transit area and as a destination for this
drug.
This year's World Drug Report indicates that coca bush cultivation
continued to decline in 2013, reaching the lowest level since 1990. With a
global prevalence of 0.4 per cent of the adult population, cocaine use
remains high in Western and Central Europe, North America and Oceania
(Australia) though recent data shows a declining trend overall. Cannabis
use is on the rise and continues to be high in West and Central Africa,
Western and Central Europe, Oceania, and North America. Data for 2013
show an increase in the quantities of cannabis herb and cannabis resin
seized worldwide, reaching 5,764 and 1,416 tons respectively.
Methamphetamine dominates the global market for synthetic drugs, and
is expanding in East and South-East Asia. Crystalline methamphetamine
use is increasing in parts of North America and Europe. Seizures of ATS
since 2009 - which have almost doubled to reach over 144 tons in 2011
and 2012, and remained at a high level in 2013 - also point to a rapid
expansion in the global market. By December 2014, a total of 541 new
psychoactive substances which have negative health impact had been
reported by 95 countries and territories - a 20 per cent increase compared
to the previous year's figure of 450.
Alternative Development as a long-term strategy against illicit crops
The 2015 World Drug Report thematic focus is on Alternative
Development, a long-term strategy aimed at developing alternative
sources of income for farmers dependent on illicit drug cultivation. This
activity is driven by many factors, including marginalization, the lack of
security, and the social and political situations of rural communities.
Alternative Development aims to reduce these vulnerabilities and
ultimately eliminate the cultivation of illicit drugs. More than 40 years of
experience have shown that this approach works when there is a long-

4. Page-4
term vision, adequate funding, and the political support to integrate it into
a broader development and governance agenda.
Marketing licit products, land tenure and the sustainable management and
use of land are crucial to the long-term success of alternative
development interventions. "Unfortunately, this year's World Drug
Report also shows that widespread political support for Alternative
Development has not been matched by funding," Mr Fedotov added, as
he urged for shared responsibility against illicit drugs. Funding allocated
by OECD countries to support Alternative Development declined by 71
per cent between 2009 and 2013, amounting to only 0.1 per cent of global
development assistance. UNODC's Executive Director noted that in the
lead up to next year's UN General Assembly Special Session on the world
drug problem, the international community's post-2015 Development
Agenda can help to promote Alternative Development efforts, with
broader interventions addressing drug supply and demand.
Statement from Mr Yury Fedotov,
Executive Director of UNODC
on International Day against
Drug Abuse and Illicit Trafficking
26 June 2015
Today is an important day for focusing on the threat of the production,
trafficking and use of illicit drugs. Robust action is needed to strengthen
criminal justice systems, break-up the criminal networks who deal in
misery and suffering, and to nurture health and human rights-based
responses.
People also endure unbelievable pain due to a lack of controlled
medications for medical purposes. Measures must be taken to ensure that
people across the globe can access pain relief where necessary. We must
also do everything to promote greater understanding of drug use as a

5. Page-5
social and health condition that calls for, like HIV/AIDS and hepatitis,
sustained prevention, treatment and care.
Science and evidence-based practices must prevail in the delivery of
prevention and treatment of drug use. These approaches are the
foundation for all our efforts. With nearly 200,000 drug-related deaths
and with 1.65 million infected with HIV in 2013, access to evidence
based prevention and treatment can sometimes be the difference between
life and death.
At present, only one in six people who use drugs globally has access to
treatment. Women face numerous barriers to treatment-while one in three
drug users globally are women, only one in five drug users in treatment
are women.
Africa, particularly West and East Africa, also remains vulnerable to the
trafficking and the consumption of illicit drugs. These trends are part of
organized crime's attack on the security, health and development of an
already-fragile region. The nexus of organized crime and terrorism-
including the apparent role of drug trafficking-is a serious threat. Opium
cultivation in Afghanistan remains a formidable challenge, as is the
production of cocaine in Latin America.
UNODC's own work shows that the balanced approach of confronting
drug supply and drug demand is fundamental. Alternative development
for farmers who cultivate illicit crops also has a major role. Alternative
development promotes environmental protection, supports communities
affected by other forms of crime, including wildlife and forest crime, and
empowers women.
Countries must also work hard to protect the promise of future
generations. Young people should be encouraged to undertake new
initiatives that can develop aspirations and opportunities, as well as
dignity.
The UN General Assembly Special Session on the world drug problem, to
be held in April 2016, can assist in the exchanges of ideas and lessons

6. Page-6
learned, and will do much to help achieve the goals set out in the Political
Declaration and Plan of Action by 2019.
On the International Day against Drug Abuse and Illicit Trafficking, and
ahead of the UN Summit on Sustainable Development, it is important to
remember that illicit drugs undermine the environment, security and
development. Countering their impact using a balanced and human rights
based approach is vital to protect and promote the health and welfare of
humankind.
Drug addicts spend Tk 70cr everyday in Bangladesh
Manzurul Alam Mukul: When the `International Day against Drug
Abuse and Illicit Trafficking` is being observed in Bangladesh like
elsewhere in the world today (Friday) then it is unfortunate that about six
million who are drug addicted in Bangladesh spend over Tk 700 million
(Tk 70 crore) every day on illegal narcotics.
Basically, drug abuse or substance abuse refers to the use of certain
chemicals for the purpose of creating pleasurable effects on the brain.
Drug abuse is a major public health problem globally. According to the
UN Office on Drugs and Crime (UNODC), between 149 million and 271
million people worldwide use the illicit drugs such as cocaine, cannabis,
hallucinogens, opiates and sedative hypnotics. The problem has been
increasing at alarming rates in recent days, especially among young
adults under the age of 30.
It is a causal factor in more than 200 disease and injury conditions; these
majorly include several types of cancer, hemorrhagic stroke and
hypertensive heart disease, cardiovascular diseases, liver cirrhosis,
neuropsychiatric diseases, etc. According to a report, illegal drug use
causes about a quarter of a million deaths per year, and use is highest in
developed countries.

7. Page-7
The harmful use of drug can also result in harm to other people, such as
family members, friends, co-workers and strangers. Moreover, the
harmful use of drug results in a significant health, social and economic
burden on society at large.
In recent years, drug addiction has significantly increased in the South
Asian countries including Bangladesh. Hundreds of thousands of youths
across Bangladesh are taking drugs on a large scale, sending our society
on the verge of ruin. Daily newspapers and televisions are full of reports
of drug network having a turnout of 1 crore (tens of millions) of taka.
This agent of human devastation has spread its tentacles to every nock
and corner.
There are three types of drugs available in Bangladesh. Opium (like,
heroin, phensidyl); Cannabis (ganja, chorosh); sleeping pill (tranquilizer,
seduxene). The most common drugs used in Bangladesh are stimulants.
The teens are ignorant about variation of drugs. Some of them cannot tell
the difference between stimulants and marijuana. There are a large
number of young using drugs.
DNC intelligence sources say heroin is the deadliest of drugs in
Bangladesh. In recent times, Yaba has gained in popularity and has
become a `fashionable` drug. Cough syrup Phensidyl has remained the
most popular among the masses because of its low price and easy
availability.
According to the police and other sources, the number of addicts in
Bangladesh is more than six million who spend over Tk 700 million (70
crore) every day on illegal narcotics.
A study conducted by the Journal of Health, Population and Nutrition
(JHPN) of the International Centre for Diarrhoeal Disease Research
Bangladesh (ICDDRB) shows that in the capital Dhaka, 79.4 percent of
the users are male and 20.6 percent are female. The study finds that 64.8
percent drug users in the country are unmarried while 56.1percent either
students or unemployed, 95.4% percent users smokers and 85.7 percent

8. Page-8
get into drugs under the influence of friends; 65.8 percent addicted to
various codeine-containing cough syrups.
According sources with different health facilities, nowadays nearly 10 per
cent of outpatients in hospitals are cases of drug addiction involving
heroin, ganja and phensidyl.
The trend of consuming drugs is higher in youth and teenagers between
15-30 years of age and come from all strata of the society. Students are
the most victim of drug abuse that lowers standards of education and
attendance at schools and colleges. There are a number of reasons why a
teenager might try drugs. The leading causes include curiosity and
excitement through use, despair and frustration for continuous failure in
works or economic insolvency, some are addicts because they try to
follow the western culture of drugs and enjoyment of life, poverty, easy
access to drugs, surrounding atmosphere, estranged in love and even
mental stress due to family problem.
According to police sources, more than 100,000 people are directly
involved with illegal drug trade and supplying. Peddlers prefer women
and children for carrying and selling drugs because it is easier for them to
evade law enforcers, sources said.
Many experts believe that Bangladesh is often used as a transit point for
international drug trafficking, making the country vulnerable to drug
abuse. Bangladesh is situated in the central point between golden
crescent (Pakistan, India, Afghanistan and Iran) in terms of geographical
location. And it is also surrounded by the major drug producing countries
of Asia, many of which are strengthening their narcotics and stepping up
enforcement measures. Traffickers who supply drugs in the markets of
Northern America, Africa and Europe are making their shipments through
Dhaka, Chittagong, Comilla, Khulna, Jessore and other routes in
Bangladesh.
So, in near future, Bangladesh will face a catastrophe if the alarming drug
abuse is not effectively checked through extensive motivation and
prevention.

9. Page-9
About the irrational behavior and drug addiction, many social scientists
blame the examples set by their elders. Firstly, parents and elders who
drink and smoke are, in effect, telling their children and juniors that it is a
socially acceptable behaviour. Consequently they may have a similar
view towards illegal drugs, even if their parents and guardians are against
their use.
In addition, drug use shown on television, films, magazines and public
displays can only attract children, if not confuse them, about the serious
health-hazards that are associated with drug abuse.
Roles of the department of narcotics control, police, RAB and BGB are
not up to the satisfactory level.
June 26 is the International Day against Drug Abuse and Illicit
Trafficking. Established by the United Nations General Assembly in
1987, this day serves as a reminder of the goals agreed to by Member
States of creating an international society free of drug abuse.
The theme for this year’s celebration is dubbed ‘Let’s Develop our Lives,
our Communities without Drugs’.
So, it is need to execute properly execution of the related law against the
spreading of drugs throughout the world including Bangladesh. Side-by-
side all conscious people irrespective of classes and professions including
parents, teachers, religious and political leaders, players and sports
personalities will come ahead to create social awareness and expedite the
anti-drug movement to save our future generation from the aggression of
the drugs.
risingbd/DHAKA/June 26, 2015

10. Page-10
Sex and the single girl, Bangladeshi-style
The result of restricting the acceptability of sex to marriage is not fewer
girls having sex at a younger age, it is more girls getting married at a
younger age
There are few issues which are so apparently cut and dried as the age of
marriage for women.
It seems self-evident that lowering the age from 18 to 16, as the
government proposes to do, is a poor idea, and I hope that the
government listens to the legions of experts and critics of the proposed
legislation, and that good sense prevails.
The argument that the age of marriage is 16 in many other countries such
as the UK (with parental consent) is irrelevant to the case at hand.
The UK does not have a problem with early marriage, Bangladesh does.
If the marriage age in the UK were raised to 18 it would make very little
difference and impact very few lives.
But in Bangladesh, the proposed change in the law would impact millions
and have far-reaching consequences, none of them good.
At a very basic level there is a lot of data out there to show that the later a
woman gets married, the later she will typically have her first child, and
that this is correlated to a raft of desirable social outcomes, both for the
woman and the child.
The later women get married and give birth, typically, the higher their
educational attainment, better their earning prospects over the course of
their life-time, and the more likely they are to be happy and healthy
throughout their lives. This much is incontrovertible.

11. Page-11
If there is one thing we should be encouraging women to do to benefit
both themselves and society as a whole, it would be to marry and have
children later.
This would also have a major impact on the country’s population
problem. We have done a great job in reducing the average number of
children each woman has to just above two, leading to a population
growth rate of 1.2% per year. Not bad at all.
The big problem we face, however, continues to be the age at which these
births occur. The math is simple. Compare the difference between a
country where a woman typically has her first child at age 20 with one
where the average age for this is 25.
In this scenario, even if women in both countries bear the same number of
children, over a period of 100 years the first country will see five
generations and the second only four, leading to massive difference in
population growth over the course of the century.
The average age of first child-birth in Bangladesh is around 18. You do
the math. The later first child-birth happens, the better for the woman, the
child, and the country.
And of course, the earlier women get married, the earlier that they will
have their first child.
There are a lot of social pressures for parents to marry their girls off at a
young age, but the government should be helping them resist this
pressure, not adding to it.
If the government started an awareness campaign and followed up with
tough prosecution for offenders, it could send a stern message and really
cut down on the incidence of child marriage.
Now it is true that many parents wish to marry their girls off early so as to
ward of the threat of harassment, rape, or assault, which become serious
and pressing concerns as soon as girls reach puberty, if not before.

12. Page-12
But in lowering the marriage age, the government is solving the wrong
problem, and it should instead focus its resources on protecting girls from
this kind of predatory behavior so that they would not have to seek the
perceived shelter of marriage to be free of it.
It is precisely because girls in their early teens are considered
marriageable that they become the object of this kind of unwelcome
attention, and often the harassment is used as a prelude to demand their
hand in marriage, with parents having no other recourse but to accede.
This is the kind of abuse that will only get worse if the government
lowers the marriage age and continues to do nothing about policing
marriage at an even lower age, instead turning a blind eye.
In addition to keeping the marriage age at 18, the government should be
cracking down both on under-age marriage and the kind of predatory
criminal behavior that makes parents think it is their only recourse. A
little government attention to this matter would go a long way.
Of course the real elephant in the room here is the social stigma which is
attached to pre-marital sex and pregnancy. One reason parents are so keen
to marry their girls off before the age of 18, and many girls themselves
wish to marry before then, is the strict societal taboo against pre-marital
sex and the disastrous consequences of unmarried pregnancy.
We need to recognise that girls may well wish to be sexually active in
their teenage years and that the best way to address this issue is to educate
them to have responsible sex and to ensure that the costs of doing so are
not so ruinous.
Many people might be appalled at such a thought, but the result of
restricting the acceptability of sex to marriage is not fewer girls having
sex at a younger age, it is more girls getting married at a younger age.
But if we are not willing to seriously grapple with and come to terms with
the issue of teenage girls having sex and the high costs of pre-marital sex

13. Page-13
in our society, then the government’s proposal is not as outlandish as it
seems.
WHO reports about Africa 2000-2015
This executive summary highlights key facts from the progress report on
the Global health sector response to HIV, 2000-2015. Successful HIV
responses are not yet universal, but they are common enough to have
made a huge impact in the past 15 years.
The number of adults and children newly infected with HIV globally
declined by 35% in 2000–2014.
The number of people dying from HIV-related causes declined by 24% in
2000–2014 and by over 40% since 2004, the peak year.
HIV treatment reached almost 16 million people in mid-2015 – more than
11 million of them in the African Region, where only about 11 000
people had been receiving treatment in 2000.
Millennium Development Goal 6, which called for halting and beginning
to reverse the spread of HIV by 2015, was achieved, and the HIV
response contributed to significantly reducing child mortality
(Millennium Development Goal 4) and maternal mortality (Millennium
Development Goal 5).

14. Page-14
Global Summary of HIV Epidemic in Women and Children,
2014
Global South Asia %
Estimated number of
women (15+) living
with HIV
17,400,000 800,000 5
Estimated number of
pregnant women
living with HIV
1,500,000 36,000 2
Estimated number of
children (<15) living
with HIV
2,600,000 140,000 5
Estimated number of
children (<15) newly
infected with HIV
220,000 14,000 6
Estimated number of
children (<15) dying
of AIDS-related
causes
150,000 9,000 6
Source: UNAIDS 2014 HIV and AIDS estimates, July 2015
HIV and AIDS estimates (2015)
Number of people living with HIV 9600 [8400 - 11 000]
Adults aged 15 to 49 prevalence rate <0.1% [<0.1% - <0.1%]
Adults aged 15 and over living with HIV 9300 [8100 - 11 000]
Women aged 15 and over living with HIV 3200 [2800 - 3600]
Children aged 0 to 14 living with HIV <500 [<500 - <500]
Deaths due to AIDS <1000 [<1000 - <1000]
Orphans due to AIDS aged 0 to 175100 [4100 - 6200]

15. Page-15
HIV/AIDS Situation of Bangladesh
Although Bangladesh continues to be a low prevalence area, it is surrounded by
high prevalence countries (High prevalence of HIV/AIDS in neighboring India).
We however must not adopt a complacent attitude in respect as 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. Drug use increases the HIV risk and can start very early-for
example, glue-sniffing by youngsters living or working on the streets. The
danger of becoming infected with HIV by sharing injecting equipment is well
known, and real. Unemployment, slum housing, family fragility, frequent cross-
border movement of people, lack of information, unsafe blood transfusion,
physical and sexual abuse-that create a "risk environment" of violence for many
young people in the region. In addition increased number of migrant workers,
unsafe practice in health service, unsafe sex practice etc. movement of
population, less use of condom, polygamy, homosexuality, extra-marital
relations, further increases the susceptibility.
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 behavioural surveillance report showed that the HIV infection
rate among the injection drug users (IDUs) is now 4 per cent, up from 2.5 per
cent previously which is just short of the 5 per cent mark of a concentrated
epidemic. About 93.4 per cent IDUs in central Bangladesh admitted that they
share same syringe while taking drugs. Even they use the same syringe several
times for taking drug.
UNCDP estimates that between 500,000 and 1,00,000 people in Bangladesh are
addicted to drugs. Although HIV rates are comparatively lower (one per cent)
among the sex workers but Sexually Transmitted Infection (STI) rates are still
quite high (20 per cent) among this group.
On the other hand, brothel-based female sex workers in Bangladesh report the
highest turnover of clients than anywhere in Asia. After several investigate on
sex industries have identified more then 1,00,000 various category commercial
and non-commercial sex workers in Bangladesh who are most of them illiterate.
Some female brothel sex workers have an average of 20-25 clients per week,
Female hotel sex worker meet an average of 44 clients in a week, the highest

16. Page-16
number of clients in commercial sex than any other counties in South-East
Asian region. Moreover the residence sex workers and floating sex workers are
present in large number though the precise distribution and prevalence is still
unknown. By a study ‘Rainbow Nari O Shishu Kallyan Foundation’ also found
that a substantial proportion of some young and single textile, garment workers,
tea garden female workers, house key-per supplement their low wages by
occasional prostitution. Consensual sex or non-commercial sex exists in rural
societies, particularly when husbands are absent for a long time.
Meanwhile, most of the people of country are unaware about the deadly disease.
The 1999-2000 Bangladesh Demographic and Health Survey found that only 31
per cent of married women and 50 per cent of newly married men had heard of
AIDS. Over 90 per cent of rickshaw pullers could not identify a single method
of HIV prevention.
Certainly, adolescent girls’ prostitution is booming in Bangladesh. Adolescent
girls engage or are forced into prostitution for trafficking or socio-economic
reasons. But in addition to sexual exploitation, they face all sorts of violence.
Rainbow Nari O Shishu Kallyan Foundation carried out a recent field
investigation, the research confirmed that adolescents girls’ prostitution is
widespread in Bangladesh, although hidden at first sight from foreigners,
especially in Dhaka city. Adolescent girls involved in prostitution are to be
found in residence homes converted into brothels or in hotels. The majority are
aged 15-18.
According to the National AIDS Committee and surveillance team members
and experts, the rate is quite alarming as it remains one per cent less than the
highest five per cent HIV epidemic index. The rate of HIV/AIDS remains less
than one per cent among the other vulnerable groups -- truckers, migrant
workers, gay, hijras (hermaphrodites), professional blood donors, heroin
smokers and, hotel, brothel and street based commercial sex workers.
A recent survey in Bangladeshi track drivers by Rainbow Nari O Shishu
Kallyan Foundation, found that 80% track driver in Bangladesh have no clear
concept of HIV or AIDS. But 90% respond it is a deadly disease. Bangladesh is
a country rounded off three sides by HIV/AIDS bloom neighboring country
India and the existence of the Bay of Bengal on the other side. Every day a
number large of people cross border movement take place both officially and

17. Page-17
also illegally. Due to reason of that great chance to spread out HIV/AIDS in
Bangladesh.
Overview of the sex industry
Commercial sex work is a growth industry. According to an analysis of data
from the National Survey of Sexual Attitudes and Lifestyles by Ward et al. [1],
the proportion of men who reported paying women for sex more than doubled
from 2.0 to 4.2% between 1990 and 2000. There has also been a diversification
of sexual services, into areas beyond the traditional exchange of sex for money.
Erotic dancing which entails less direct sexual contact between worker and
client and other private sex work advertised on the Internet have become
increasingly prevalent [2,3].
The sex industry is diverse in the ethnic origins of sex workers, many of whom
are economic migrants and include women trafficked and coerced into sex work
by organized crime networks [4]. There has been a demographic shift in the
origin of commercial sex workers (CSW) working in west London between
1985 and 2002, with a reduction in the proportion with British nationality from
75 to 37%, and a corresponding increase seen in workers from the transitional
economies of Eastern Europe and Russia (1–20%) and developing countries,
particularly Asia (5–27%) [5]. The Poppy Project, in a survey of female sex
workers across London, identified 93 different ethnic groups among women
working in off-street premises, of whom only 19% were British [6]. This influx
of individuals from many countries inevitably generates language and cultural
barriers in access to health and other services.
The pathways that lead people into commercial sex work are also varied. At one
end of the spectrum are those who work autonomously, undertake sex work by
choice and are well organized with respect to their sexual health and accessing
services [7,8]. These workers may have entered sex work for a specific reason
(e.g. to fund higher education costs, pay debts or to cover family expenses),

18. Page-18
may be intermittent or opportunistic in their involvement in sex work [9] and
succeed in exiting the industry at a time of their choice [10]. Others make a
career decision to work in the sex industry and may enjoy a high level of job
satisfaction and independence [11]. In contrast, are those who are driven into
commercial sex work through drug addiction or coercion, and have little
autonomy. These workers, including women sold for the purposes of
trafficking, are highly vulnerable and have little prospect of leaving the industry
unassisted [4,12]. Between these extremes lie the majority, who work in the
industry due to varying degrees of economic necessity and choice [8].
There are significant differences between indoor work and street work, in terms
of harm and risk to health. Street sex work is more likely to be linked with
drugs [13,14] and many in the UK have entered the industry primarily out of the
need to maintain expensive drug addictions to heroine and crack cocaine. In this
setting, sex may either be exchanged directly for drugs, or drugs may be
supplied by the pimp in exchange for earnings [15]. As a result, they are likely
to be exposed to much higher levels of violence and abuse from clients and
pimps than those who work indoors [16]. Pressure from clients for unprotected
sex combined with drug dependency and competition among workers for clients
lead street workers to offer, or be persuaded to accept unprotected vaginal or
anal sex for more money [3,8,17]. Furthermore, street workers are often
homeless, living in squats or drug dens, which may in turn have an adverse
impact on health through the acquisition of tuberculosis and other respiratory
diseases [4,13].
In contrast, workers who are based in off-street premises, whether in flats,
saunas or massage parlours, are less exposed to the risk of violence and will
generally work with a maid or a manager who can vet clients, look after money
and provide security [18]. Indoor workers are more likely to have autonomy in
working hours and the disposal of their income, and are less likely to be
supporting an addictive drug habit or to be under the control of pimps [19]. As a
result, these workers are not compelled to agree to unsafe sexual practices for
higher earnings, and use condoms with all clients [20]. Trafficked women and
children who have been groomed and coerced into sex work are important
exceptions to the paradigm that indoor sex work offers greater protection [4].

19. Page-19
Here the individuals concerned are hidden from view to avoid detection by
police and social services, and may frequently be moved between locations or
across international borders.
Finally, sex work is not gender specific. The existence of a market for male sex
workers who offer services to male or (less commonly) female clients is well
recognized [21,22]. Transexual and transgendered individuals also participate in
the sex industry, and have their own particular needs [8,23].
Research into commercial sex work is hampered by several methodological
challenges. First, the study populations are usually small and unrepresentative
due to problems gaining access to sex workers and establishing trust. As a
result, researchers are reliant on individuals who attend sexual health clinics
voluntarily, who may be poorly representative of the local CSW population,
particularly the more vulnerable groups. Second, there is likely to be reporting
bias in response to questionnaires or structured interviews on topics such as
condom use and drug habits [24,25]. Third, the heterogeneity of CSW with
respect to adherence to safer sex, drug misuse and local factors such as pimping
and policing means that generalizability of results may be limited. Finally, CSW
represent an unstable population both temporally and geographically, which
means prospective studies are difficult to conduct without the loss of significant
numbers of subjects, which itself may bias results.
Risks to health
There are four main categories of health risks faced by workers in the
commercial sex industry. These relate to the acquisition of sexually transmitted
infections (STI), harm through violence from clients or pimps, factors
associated with the use of drugs and mental health.
Acquisition of STI
Bacterial (syphilis, chlamydia, gonorrhoea and Mycoplasma genitalium) and
viral STI [human immunodeficiency virus (HIV), hepatitis A, B and C, herpes

20. Page-20
simplex virus (HSV) and human papilloma virus] are acquired mainly through
unprotected vaginal, anal or oral intercourse. Some STI, such as chlamydia and
gonorrhoea, cause mucosal inflammation, while others, including primary
syphilis and HSV, produce ulceration. HIV, hepatitis B and C and syphilis are
also transmitted through injecting drug use. Individuals who are both CSW and
intravenous drug users have a dual risk of acquiring these infections.
There are numerous long-term sequelae of STI. Chronic infection with
gonorrhoea and chlamydia causes pelvic inflammatory disease leading to higher
rates of ectopic pregnancy and infertility. Tertiary syphilis causes neurological
and cardiovascular complications. Chronic infection with hepatitis B or C can
give rise to liver cirrhosis and hepatocellular carcinoma, while cervical and
other anogenital neoplasia are associated with certain subtypes of the human
papilloma virus. HIV infection causes progressive immunodeficiency which in
turn leads to life-threatening opportunistic infections and cancers. Co-infection
with HIV and hepatitis B or C is associated with a worse prognosis than with
either alone. The majority of STI can be acquired congenitally and produce high
levels of morbidity in neonates and infants.
It has generally been assumed that commercial sex work facilitates the spread of
STI in a population [26], but research suggests that this may only apply in
certain settings such as the developing world and street sex work, where
condom use may not be widely practised [27,28]. The overall prevalence of
HIV among UK CSW ranges between 0 and 3.5% [29] while a study from 11
European centres found an HIV prevalence of 1.5% among non-injecting CSW
but 31.8% among injecting drug users [30]. A relatively low level of STI in
female CSW attending a clinic in west London was also reported [31,32], and
attributed to a high level of condom use. Infection rates were still above those
for the general population, but this was largely explained by indirect factors
such as injecting drug use and having unprotected sex with non-commercial
partners who may themselves be injecting drug users [20]. This suggests that
even in the context of drugs and street work, it is possible for workers to
negotiate barrier protection with clients given the necessary skills.

21. Page-21
Harm through violence
Physical violence is perhaps the greatest single threat to the health and well
being of CSW. According to Kinnell [33], 87 CSW have been murdered in
Britain since 1990. A questionnaire survey of 115 street or outdoor and 125
indoor CSW working in Glasgow, Edinburgh and Leeds conducted by Church
et al. [16] found that outdoor workers were twice as likely to report violence
such as beatings, stabbing, rape and robbery, than indoor workers. Outdoor
workers in Glasgow had a six times greater risk of violence than indoor CSW in
Edinburgh. Only one-third of assaults were reported to the police. Among
street-based CSW, economic pressures, use of heroine or crack cocaine while
working, not being able to control the location for sex and having sex in the
client's car were all strong predictors of violence. Norton-Hawk [17] also found
that being under the control of a pimp increased the likelihood of violence,
partly because of the pressure to earn extra money. These women were more
likely to be single, to have come from dysfunctional families and never to have
held a legal job. In general, licensed brothel workers felt more secure than in the
street setting owing to the closer proximity of fellow workers, the provision of
security systems and the right to legal protection [13,34].
Factors associated with use of drugs
Intravenous drug use is associated with multiple medical complications,
including cellulitis and abscesses at injecting sites, deep vein thrombosis,
pulmonary embolism, bacterial endocarditis, septic embolization, rehab
domyolysis and death through overdose or contamination with toxins. Sharing
needles and syringes contributes to the risk for acquiring HIV, hepatitis B and C
and syphilis, and this accounts for the majority of infections among CSW who
are supporting opiate addictions [35]. Other drugs such as cocaine, crack
cocaine and crystal methamphetamine can lead to cardiovascular and
neurological disease and immunosuppressant.
In general, CSW who inject drugs exhibit higher levels of risk-taking behaviour
compared with non-CSW, including higher injection frequency, use of crack
cocaine, higher rates of sharing injecting equipment and use of shooting
galleries [14,36,37]. HIV prevalence was 32% among CSW and 21% in the

22. Page-22
non-CSW group (14). Non-injecting drug use, particularly smoking crack
cocaine, has been implicated as an indirect risk factor for STI transmission
through impairment of judgement, leading sex workers to engage in higher risk
behaviours than non-crack users [15,23,38].
Mental health
There is a strong relationship between mental ill-health and risk-taking
behaviours (drug use or sexual practices) among CSW [39]. Several studies
have reported higher levels of psychological distress levels in CSW, than a non-
CSW control group, even after adjusting for confounding factors such as age,
previous rape and crack cocaine use [37,40,41].
What remains unclear is the relative contribution to the distress of working as a
sex worker versus pre-existing psychological trauma as a result of drug use,
previous childhood abuse, domestic violence or imprisonment. Van wizen beck
[42] partly addressed this issue in an assessment of ‘burnout’ among 96 CSW in
Holland, using measures of emotional exhaustion, depersonalization and
personal competence in comparison with a group of female nurses. Increases in
the first two were attributed to factors such as coercion, violence, negative
social reactions, lack of control with clients and inadequate support from
managers. Personal competence was positively associated with having a
professional attitude towards sex work and with support from colleagues and
managers. It was concluded that the conditions under which sex work are
conducted have a greater influence on the worker's psychological well being
than the nature of the work itself.
Male and transgender sex workers
The term ‘transgender’ refers both to transsexuals, who display many of the
physical attributes of the opposite sex while retaining their natural genitalia, and
individuals who have undergone gender reassignment surgery. In terms of
commercial sex work, both groups are usually male-to-female transgenders.
Transvestites, men who dress as women but do not undergo hormonal or
surgical modification, are not considered here in the context of sex work.

23. Page-23
Male CSW
Male CSW may be homosexual, bisexual or heterosexual in orientation, and
although typically viewed as servicing male clients, a significant proportion also
engage in sex work with female clients [21,22].
In a study of 94 male CSW attending sexual health clinics in Sydney, 6.5% of
the male CSW were HIV positive, compared with 0.4% of the female CSW and
24% of non-CSW homosexual men, but 21, 5 and 12%, respectively, had
anogenital warts [21]. Injecting drug use was twice as common among male
CSW than in the other two groups and was significantly higher among workers
who reported female non-paying clients than among those whose non-
commercial partners were male. Overall, male CSW had significantly more
non-paying partners than female CSW. Eighty-six per cent of male CSW
reported 100% condom use with clients in the past 3 months compared with
88% of female CSW. In contrast, only half reported consistent condom use with
non-paying partners.
Male-to-female transgender CSW
Transgenders form a special group of sex workers in terms of their risks and
needs. Discrimination in conventional job markets leads a high proportion to
engage in commercial sex work [43]. Incentives to earn money are perhaps also
higher in this group compared to other groups of sex workers due to the costs of
gender reassignment surgery and hormones used to enhance feminine physical
attributes.
Misuse of other drugs is high among transgenders, and reported rates of HIV,
hepatitis and syphilis are correspondingly increased [44]. Transgenders also
report high rates of needle sharing, both for illicit drugs and for hormones. Post-
operative transgenders may engage in both vaginal and anal intercourse, and it
has been suggested that surgically constructed vaginas are more susceptible to
transmission of HIV and other STI [45]. Transgenders are heavily stigmatized
in society, even by other sex workers, and are at high risk both of violence from

24. Page-24
clients and of being coerced into providing unsafe sexual services for more
money [46,47].
The Home Office published a document in 2004 entitled ‘Paying the Price’ [48]
which proposed policies for tackling the commercial sex industry. Emphasis
was placed on disrupting sex markets to achieve an overall reduction in street
work, taking measures to protect communities from the associated ‘nuisance’
and reducing all forms of exploitation in the industry. Following a period of
public consultation, the government document ‘A Co-ordinated Prostitution
Strategy’ [49] was published in January 2006.
Responses to both documents have been generally unfavourable. Boynton and
Cusick [50] point out that the government's failure to address health and human
rights for sex workers will undermine efforts to reduce exploitation and
minimize harm. For example, it remains illegal for more than one individual to
sell sex from indoor premises at one time. As maids are to be classified as
‘controlling prostitution’, sex workers will be compelled to operate alone
despite the increased vulnerability that this entails [8]. The government's refusal
to license indoor workplaces also acts as a barrier to ensuring that such premises
conform with employment and health and safety legislation, and do not harbour
children or trafficked women.
The UK Network of Sex Work Projects pointed to the negative effects of anti-
kerb-crawling legislation and the use of Anti-Social Behaviour Orders against
street workers in pushing the industry further underground. Criminalization
affects access to services and the job market while also hampering the efforts of
outreach workers in delivering services to those who are most vulnerable.
Furthermore, disrupting demand increases competition between workers and
encourages more risky behaviour. The UK Network of Sex Work Projects
(UKNSWP) also criticized the government for ignoring the benefits that would
result from regulating off-street premises and improving conditions for the
many who work in the industry out of choice.
The UKNSWP calls for managed zones for street sex work, pointing to the
success of projects in Holland and Cologne. By relocating street work to non-

25. Page-25
residential areas, managed zones improve safety for workers, build good
relations with the police, allow regular access to services and reduce the
interdependence between street work and drugs. Such proposals were well
received in consultations with street workers throughout the UK [8].
Assessment of needs
Service provision to this highly heterogeneous population needs to be tailored to
the local needs expressed by sex workers themselves, which are shaped by the
individual's own professional, behavioural and social context. For example,
street workers may perceive drug dependency or the associated violence from
dealers and pimps as their principal problem, while for others, the main
requirement may be for suitable housing or childcare. Several surveys of female
CSW in London have found that demand was greatest for housing, followed by
sexual health and substance misuse services. In contrast, among those wishing
to exit the industry, provision of safe house and hostel accommodation,
counselling services and peer support groups were highlighted. Other gaps in
service provision included dedicated exiting programmes, outreach services,
treatment for depression, support following sexual assault, education
programmes and community safety strategies [19,24,51].
It is important to recognize that many sex workers are reluctant to seek help
through mainstream services such as genitourinary medicine (GUM) clinics and
general practitioners for fear of stigma and disapproval [19,23,51]. Service
providers must therefore be prepared to overcome these barriers and seek to
establish trust by providing surroundings in which confidentiality, non-
judgemental attitudes and sympathetic listening predominate [7]. De-
stigmatized delivery of service is more likely to be encountered in settings
dedicated to sex workers, rather than through piecemeal access to mainstream
services for sexual health, drug rehabilitation or housing.
Harm reduction
Services aimed at harm reduction need to address the four main areas of risk
discussed, namely, sexual health, physical violence, drug use and mental health.

26. Page-26
Sexual health services should include screening for, and treatment of STI,
provision of condoms, and education to reduce disease transmission. Mallory
and Gabrielson [3] reported that ∼8- to 12-h training is required to impart
lasting safer sex behaviours. Effective measures include practice with condom
application, and the development of assertiveness and negotiating skills with
clients through role play [52]. Sexual health services should also offer
reproductive health care, including cervical screening, family planning,
management of gynaecological problems and referral for more specialist
services such as colposcopy, termination of pregnancy and psychosexual
counselling [53].
Reducing the risk of violence towards sex workers depends on a range of
strategies that includes safety advice, awareness of potentially dangerous
clients, training in assertiveness and negotiating skills and distribution of
‘dodgy punter’ registers based on physical descriptions provided by CSW
[7,8,48,54].
Harm reduction in relation to drug use is critically important as a means to
protect the individual from the risks of both infection and violence. Needle and
syringe exchanges reduce the need to share equipment and visit shooting
galleries, and can provide the opportunity for education in safer injecting
practices [14,37]. Drug rehabilitation and methadone programmes, as well as
those which treat addiction to crack cocaine, are therefore an essential means by
which the individual can withdraw from the drug culture [23].
Sex workers who have experienced violence or abuse in early life, or who
continue to be exposed either through their work or in their non-commercial
partnerships, are likely to suffer in varying degrees from conditions such as
depression and post-traumatic stress disorder. These problems require careful
evaluation and counselling [3,55] backed up by practical measures such as the
provision of emergency housing.

27. Page-27
Peer support is recognized as an important means by which important
information about safer sex and the reduction of risk from violent clients can be
passed between workers [23,56,57]. CSW who act as peer educators are likely
to be more successful than health care workers in promoting condom use with
both commercial and non-paying partners [24].
Drop-in clinics and outreach
Most dedicated services for CSW concentrate on sexual health, either in the
form of clinics or through outreach providers visiting both indoor premises and
street locations [24]. The principal role of outreach is to distribute condoms,
provide clean needles and syringes, offer information and advice on safer sex
and sexual health and refer sex workers to clinic-based services for STI
screening and other health needs [7]. Advice may also be offered on safety,
access to drug programmes, housing services or legal assistance. One successful
pilot scheme in Liverpool involved engaging a wide range of CSW including
male workers. A nurse practitioner established links with escort agencies,
indoor premises, street workers and a number of outreach projects in order to
build trust and provide fast-track clinic appointments for both workers and their
partners [51].
Drop-in services for CSW are typically based either in general GUM clinics or
in outreach settings, such as general practitioner (GP) surgeries in areas where
the sex industry is concentrated. Donegan et al. [58] found specific services
offered by 25 GUM departments in the UK providing various combinations of
outreach workers, drop-in clinics and outreach clinics. Cooper et al. [59]
identified 81 dedicated services for CSW across the UK in a 1995 survey, and
124 in 1999. Most provided outreach and were geared towards harm reduction.
Another model is the Working Women's Project in Streatham, South London
run by Mainliners, and based in a primary health care centre. Staff include a GP
and female nurses from the nearby Caldecot Centre for Sexual Health at Kings
College Hospital. The project provides a full range of services, including sexual
health screening and information, pregnancy testing, referral for abortion and
other gynaecological problems, contraceptive advice, information on safer sex

28. Page-28
and drug use, free condoms, a needle exchange, general medical care, an ‘ugly
mugs’ list, emotional support and advice on legal issues. Referral can also be
made to other services including counselling, housing and drug programmes.
Exit strategies
Workers who wish to leave the sex industry may face multiple obstacles
depending on their level of vulnerability [12]. For example, street-based CSW
may need protection from pimps or violent partners through the emergency
provision of safe houses or shelters, referral to drug rehabilitation programmes
or counselling services to address mental health issues. Low educational level,
learning difficulties and a criminal record can also act as barriers to the
reintegration of sex workers into the non-sex workforce [7].
Exit programmes therefore need to be holistic and tailored to individual
vulnerabilities, which is best achieved through coordinated referral to the
relevant agencies and the provision of long-term follow-up [8]. Clark and
Squires [7] proposed the establishment of Vulnerable Adult Protection
programmes in which the coordinating role would be taken on by a key worker.
In such a model, an initial intervention to provide safe house accommodation
could be followed by referral to drug rehabilitation or sexual health services,
and ultimately lead to training in new skills and assistance with job seeking. The
Sex Workers in Sexual Health Project in Coventry reported on 10 CSW who
had successfully exited over 2 years [60], but few services exist owing to
funding constraints and lack of multi-agency co-operation, with the majority
concentrating on harm reduction rather than exiting.
Sex workers in the UK will continue to face multiple hazards for as long as the
occupation continues to be seen as a policing problem rather than a welfare
issue. Clear distinctions need to be drawn between coerced and non-coerced sex
work, and recognition given to the heterogeneity and differing needs of this
population in order to be able to target interventions appropriately.
Decriminalization would open the way for the licensing of indoor premises and
the establishment of managed zones for street sex work, which would in turn
provide a stable setting for the effective implementation of strategies for harm

29. Page-29
reduction and exiting. Until such a time, however, existing services will
continue to be fragmented and under-funded to the detriment both of sex
workers themselves and the wider community.
Human rights: Bangladesh’s LGBT Community and the UPR 2015
Bangladesh will be subject to Universal Periodic Review (UPR) on April 29.
The UPR is a mechanism of the United Nations Human Rights Council
(UNHRC) that will examine Bangladesh’s overall human rights performance
during the last four and a half years. It will be the second UPR cycle, following
the first one in 2009.
The UPR aims at improving the human rights situation on the ground in each of
the 193 United Nations (UN) member states. Each UN member state is
subjected to this review every four and a half years. The reason UPR is
important for Bangladesh, or any state for that matter, is the opportunity for
stakeholders to submit their own reports along with the one from the
government. The mechanism has hence proved to be very popular and powerful
in upholding the human rights of marginalized or disenfranchised groups.
The sexual and gender minority community of Bangladesh has also discovered
this new mechanism as a way to raise awareness for the violations of their
human rights on an international platform. In 2009, based on reports prepared
by local rights groups, Chile and the Czech Republic made three
recommendations to the Government of Bangladesh that, if implemented, would
improve the legal status of lesbian, gay, bisexual, and transgender (LGBT)
persons in Bangladesh.
Two of the recommendations were to decriminalise same-sex relationships by
abolishing Section 377 of the Bangladesh Penal Code, which is a remainder of
British colonialism. Another recommendation was to educate law enforcers and
judicial officers about LGBT issues, and to adopt further measures to ensure the
protection of LGBT persons against violence and abuse.
The Government of Bangladesh rejected the first two recommendations, saying
that “Bangladesh is a society with strong traditional and cultural values. Same-
sex activity is not an acceptable norm to any community in the country. Indeed,

30. Page-30
sexual orientation is not an issue in Bangladesh. There has been no concern
expressed by any quarter in the country on this.” The government, however,
accepted the recommendation of training law enforcers to protect sexual and
gender minorities.
When Bangladesh comes under review for the second cycle in a few days, more
specific recommendations from UN member states are expected to ease the
plight of LGBT people. But, given the current political situation of the country,
the issue may be dumped way beneath the pile of other issues. That is why it is
important that the media, civil society and the community endorse the cause of
sexual and gender minorities.
Boys of Bangladesh (BoB), the largest platform of self-identified gay men in
Bangladesh, have put forward a number of recommendations from the LGBT
community in the stakeholders’ report this year. One of the main
recommendations is to conduct a government survey about human rights
violations victimizing LGBT persons in the country. Such a survey is necessary
to learn more about the discrimination, stigma and violence LGBT persons face
in Bangladesh, and to develop strategies to address these human rights
violations.
The government already has an extensive HIV/AIDS program under the
Ministry of Health, which also includes men who have sex with men (MSM)
and Hijras. Hence, the government’s claim that sexual orientation is not an issue
in the country is only a way to brush aside the realities, and to avoid
acknowledging human rights violations of sexual and gender minorities.
BoB thinks that it is time for the government to acknowledge the existence of
this clandestine but significant population, and to take appropriate measures to
address the violations of their human rights. After all, sexual and gender
minorities are part of every family, every society and are integral development
partners of the country.
The writer is a human rights activist and a volunteer at Boys of Bangladesh
(BoB), a non-registered, non-funded, informal network of self-identified gay
men in Bangladesh.

31. Page-31
Shame and Guilt over being Homosexual
Do you experience shame and guilt over being gay or homosexual? It's easy for
me to say, 'Stop, there's nothing to be ashamed about!" But it's a lot harder to
put into practice. The reason for this is that the seeds for shame and guilt are
usually sown over a period of many years, since we were very young. In the
United States, shame and guilt over being homosexual have their roots in
religious philosophy. Religious prejudices have heavily filtered into our legal
system, making gay sex illegal in many states and failing to protect gays in most
states.
These societal beliefs and laws influence how we are raised by our parents,
what our schools teach us and how other people respond to us. Believe it or not,
all cultures do not share a negative view of homosexuals. Latin American
countries, the Philippines and Sweden are just a few examples of countries that
have tolerant laws and attitudes toward gays and lesbians. In general, societies
that believe that homosexuality is a born trait are more accepting than societies
that think it is a choice. Of course, we as homosexuals know it is not a choice!
So what are shame and guilt exactly? They are not quite the same. Shame is
experienced in reference to how other people perceive your actions; guilt is
experienced in reference to how you perceive your actions. Is it possible to
experience one without the other? Yes, and it is also possible to experience both
at the same time. For instance, if you are a woman, you may feel absolutely no
guilt whatsoever when you are intimate with your girlfriend. You are joyful, at
peace and fulfilled. However, when it comes time to tell another about the
experience, you may have a sense of deep shame. Conversely, you may
experience guilt when you are together and shame when you tell someone else.
Try to figure out what your feelings are, when you feel them and what triggers
these feelings. Ask yourself some hard questions. Do these feelings arise from
learned religious convictions? Did my parents teach me these things? When was
the first time you heard anti-gay sentiments and what were your feeling then?
Then do a reality check. If you have been an active homosexual you know the
truth of what you do, how you feel about your partner and the relationship that
you have. Unfortunately, when you examine reality you will discover that the
people that wrote the laws, taught you and influenced your thought have no idea

32. Page-32
what they are talking about. They developed all those prejudices and
perspectives, laws and mores, based on fear, poorly interpreted ideology and
ignorant judgment. All of these negative beliefs have been developed without
any scientific basis or with respect to modern psychiatric insight and findings.
It takes a long time to overcome feelings of shame and guilt. Talking about it is
extremely important and may help you get perspective on the subject. You may
consider joining a more accepting church or synagogue if religion is a problem.
For instance, Unitarians and Reformed Jews are examples of religion sects that
do not discriminate against gays and lesbians. Overcoming shame and guilt will
go a long way toward helping you come out successfully, accept yourself for
who you are and have a healthy relationship with your partner.
Where does Bangladesh stand on homosexuality issue?
Bangladesh is one of 75 countries that currently have laws criminalising
homosexuality. In Bangladesh, the highest punishment for "unnatural
intercourses" is life imprisonment, but lesser jail terms of up to 10 years in
prison and fines might also be handed out under the existing law. According to
the Section 377 of the penal code, voluntary carnal intercourse against “the
order of nature with any man, woman or animal” is punishable with
imprisonment for life or with imprisonment which may extend to ten years and
fines.
This phrase is interpreted to mean all forms of sexual activity other than
heterosexual penile-vaginal intercourse. Penetration is sufficient to constitute
the carnal intercourse necessary to the offence described, the Section 377 also
explains. Talking to the Dhaka Tribune, Supreme Court lawyer Jyotirmoy Barua
said being gay or lesbian was punishable under that section in Bangladesh. Even
though a small number of gay rights organisations and activists in Bangladesh
were raising their voice to establish rights for the LGBT community, none of
them has so far engaged in a legal fight to recognise the status of lesbian, gay,
bisexual and transgender (LGBT) people in the country, said Jyotirmoy.
Of the 75 countries that criminalise homosexuality, most are located in Asia and
Africa, while more than half are commonwealth countries. On the other side of
the coin, nineteen countries – most of them located in North America, South
America and Western Europe – recognise same-sex marriage and grant most

33. Page-33
LGBT rights to its citizens. In December 2008, Bangladesh was one of 59
countries that signed a statement opposing LGBT rights at the United Nations
General Assembly. However, in January 2014, the Bangladesh government
granted hijras, who are neither male nor female, official recognition as a
separate gender. The move was made to ensure all hijras get priority for
education and other rights. In South Asia, the only case of legal fight
challenging the criminalization of homosexuality took place in India.
In 2001, an NGO there fought a legal battle challenging the constitutionality of
Section 377 of the India Penal Code, which has similarity with the section 377
of the penal code of Bangladesh, but it was finally turned down by the Indian
Supreme Court. According to Amnesty International, human rights abuses
based on sexual orientation or gender can include violation of the rights of the
child; the infliction of torture and cruel, inhuman and degrading treatment;
arbitrary detention on grounds of identity or beliefs; the restriction of freedom
of association; and the denial of the basic rights of due process.
Some examples of such abuses include execution by the state; denial of
employment, housing or health services; loss of custody of children; denial of
asylum; rape and otherwise torture in detention; threats for campaigning for
LGBT human rights and regular subjection to verbal abuse, says Amnesty
International. Source: Dhaka Tribune