Md. Jahangir Alam:

The HIV/AIDS situation in Bangladesh is increasingly concerning. Over the past year, new cases have risen by approximately 39%, with nearly half of the new patients identified as men who have sex with men (MSM). According to data from the Directorate General of Health Services (DGHS) AIDS/STD program, the highest number of new AIDS patients this year were reported in Dhaka district, where 334 new cases were identified. Comilla district recorded 108 new patients, while Chittagong and Khulna reported nearly 100 new patients each. By division, the Rajshahi division recorded the most new cases this year, with Sirajganj district having the highest number within the division.

Concerns About MSM Population

Experts report that MSM have become a point of societal concern. Although it is unclear exactly who is engaging in high-risk behavior, evidence suggests that infections are spreading from this group to the general population. DGHS data shows that the number of MSM in Bangladesh increased from 111,000 in 2015 to 167,000 in 2023. Current records indicate that approximately 50% of all identified HIV patients are MSM.

Md. Alauddin Chowdhury, Manager (Data and IT) of the DGHS AIDS/STD program, explains that increased awareness among suspected patients, reduced stigma, and expansion of government and NGO HIV prevention and treatment programs have contributed to higher testing and screening rates. This, in turn, has led to the identification of more infections, particularly among MSM.

Recent HIV Statistics

According to the National Tuberculosis, Leprosy, and AIDS Control Program (TBL & ASP):

• From November 2024 to October 2025, approximately 2,000 people were newly diagnosed with HIV, up from 1,438 the previous year.
• 200 deaths due to AIDS were recorded, slightly higher than the previous year’s 195.
• Many newly identified MSM are engaging in risky behavior, raising concerns about the spread of the virus.

Geographic Distribution

Dhaka division reported the highest number of new cases, attributed to high population density, uncontrolled risky behaviors, and limited access to regular healthcare for high-risk populations. This situation coincides with World AIDS Day 2025, observed on December 1. The UN AIDS theme for this year is: “Remove all barriers, build an AIDS-free society.”

Historical Context and Global Goals

HIV was first detected in Bangladesh in 1989. Thirty-five years later, the country has recorded its highest number of infections in a single year. To meet the UN SDG 3.3 HIV targets by 2030, Bangladesh aims to:

1. Identify 95% of all HIV-positive individuals.
2. Ensure 95% of diagnosed patients receive treatment.
3. Maintain viral suppression in 95% of treated patients.

Currently, the reality falls short of these targets.

• Total diagnosed HIV cases: 16,863
• Deaths: 2,281
• Patients receiving treatment: 8,309

Case Study: Life of a Young MSM Patient

A 21-year-old student (pseudonym: Suman) from North Dhaka is receiving treatment at the ART center of the Infectious Disease Hospital. He contracted HIV after engaging in unprotected sexual activity with a senior member of a local acting training center. Suman was diagnosed after developing a rash and undergoing blood tests at a private hospital, with confirmation at the Combined Military Hospital. He has been on regular ART medication for two months but has not disclosed his condition to his family.

Hospital Data Insights

• From November 2023 to October 2024, 2,486 individuals were tested for suspected HIV, with 184 positive cases: 141 men, 38 women, 4 hijras, and 71 MSM.
• 107 cases resulted from unprotected heterosexual activity, 10 from mother-to-child transmission, and 42 involved returning migrant workers.
• During this period, 32 patients died from AIDS-related complications, including 7 before starting treatment.
• From November 2024 to October 2025, 2,192 people were tested, identifying 273 HIV-positive individuals: 215 men, 57 women, and 1 hijra.
• Among these, 78 were MSM, 39 male sex workers, and 138 from the general population. During this period, 35 patients died.

Challenges in Treatment and Healthcare

Doctors report that most new patients are young adults aged 20–30. Returning migrant workers and those engaging in risky sexual behaviors form a significant portion of new cases. While ART medication is provided free, hospital resources are limited:

• Advanced tests like MRI, biopsy, and CD4 count are not fully available.
• Facilities for diagnosing fungal and parasitic infections, dialysis, and life support are lacking.
• Supply of advanced antibiotics is limited.

Dr. ARM Sakawat Hossain, hospital consultant, notes a shift in patient demographics, including migrant workers and professionals engaging in risky behaviors, contributing to increased infection risk.

Prof. Nazrul Islam, former Vice-Chancellor of Bangladesh Medical University, emphasizes that while HIV treatment has improved, infection and mortality rates remain high. Factors include irregular treatment adherence, efficacy of medications, and the rising infection rate among MSM. He stresses the urgent need for stronger preventive measures to avoid larger public health risks.

Conclusion

Bangladesh faces a growing HIV/AIDS challenge, especially among MSM and young adults. Despite progress in treatment, gaps in prevention, diagnostics, and healthcare access remain. Urgent action is needed to strengthen awareness, testing, treatment adherence, and targeted interventions to control the epidemic and protect public health.