Bangladesh is at a critical moment in its emerging epidemic of acquired immune deficiency syndrome (AIDS).The prevalence of human immunodeficiency virus (HIV) in the population remains relatively low by official estimates, yet several factors suggest the risk of a devastating epidemic.Bangladesh is neighbor to major epidemics in India and Southeast Asia, and there is a good deal of migration across national borders.Bangladesh has a high rate of poverty, systemic gender inequality, and an inadequate health care system.Behavioral surveys have shown that sex workers and men who have sex with men often have unprotected sex, and injection drug users often share needles, in some cases because alternatives to these behaviors are limited.There is growing recognition within the Bangladesh government and among international agencies that the country must take immediate, concerted action to avoid a severe AIDS epidemic.
The Bangladesh national AIDS policy acknowledges that persons most at risk of HIV transmission-such as sex workers, men who have sex with men, and injection drug users-are essential partners in any successful fight against AIDS.These are the people in greatest need of HIV/AIDS information and services, and they are also often the people in the best position to deliver information and services to their peers.And yet Human Rights Watch found in investigations conducted in December 2002 that the Bangladesh government both commits and condones the commission of severe violations of the human rights of persons in all three of these high-risk groups, including peer educators who provide vital HIV prevention services.
Both sex workers and men who have sex with men are regularly abducted, raped, gang-raped, beaten, and subject to extortion by the police and by powerful thugs termed mastans.Mastan is the name given to criminals who sometimes act as musclemen for Bangladesh's political parties in exchange for the parties' tolerance of the mastans' racketeering and other criminal activity.Today the term is used to refer not only to thugs with direct political affiliations but also more broadly to powerful criminals.
One sex worker from Dhaka, Jahan H., told Human Rights Watch that in September 2002 a police officer locked her in a hotel room for two days during which he beat her with a belt and raped her seven times.The officer also brought three of his friends into the room, each of whom raped her.She reported being raped by police officers several other times in 2002, and being raped as often as once a week by mastans.In mid-2002, she was forcibly taken to a warehouse and raped by seven mastans throughout the night.Jahan H.'s experiences are not anomalous.Another sex worker, Lani N., twenty, reported she was raped by police officers three times in 2002.She also said that one night in late 2002 she was forced onto a bus and taken to a place where she was raped and beaten by about twenty mastans.
Twenty-year-old Rakesh K., who identified himself to Human Rights Watch as a man who has sex with men, said that in December 2002 a police officer brought him to a police barracks where he was raped by four officers.Rakesh K. also said that mastans raped him approximately four to five times per month in the months prior to meeting Human Rights Watch.He said that mastans usually would rape him in groups of two or three and also would take his money.
Sex workers and men who have sex with men encountered by Human Rights Watch were often arrested seemingly for the purpose of the same kinds of abuse-rape, beatings, and extortion-rather than for law enforcement.When three police officers arrested twenty-year-old Shipna B. in late 2001, they did not charge her with a crime or even take her to the police station.Instead they demanded a bribe; when she was unable to pay it, one of the officers raped her.
The police deal a direct blow to Bangladesh's anti-AIDS efforts by beating and arresting sex workers and men who have sex with men who work on HIV/AIDS outreach and education among their peers.Peer education is among the most effective and sometimes the only way to bring HIV information, condoms, and other services to these hard-to-reach persons.One outreach worker from Dhaka, Ali L., was beaten by police while distributing condoms and conducting HIV/AIDS education among men who have sex with men."[The police] hit me with a cane, with their gun, they kicked me and slapped me and pulled my hair and pulled on my collar and the waistline of my pants."
Perpetrators of sexual violence and other forms of abuse are not held accountable by either the police or the government.Both sex workers and men who have sex with men reported that their attempts to make official complaints about the abuses they experienced were largely ignored and sometimes ridiculed.Durga R. said she had been raped by police officers more times than she could count, and that she had tried to complain about these rapes once, in late 2001.She spoke to a high-ranking police officer who told her that if police wanted to have sex with her she should "make them happy."He asked her how else she expected to do business in the street.She said that was the only time she complained.
Partly this impunity reflects broader social attitudes which stigmatize both sex workers and men who have sex with men.They are ostracized by their families and communities and denied access to education, employment, housing, and health care.Both groups are portrayed as inherently "bad" and face constant attacks on their dignity.They are particularly vulnerable to sexual violence, which is justified both by the perpetrators of the violence and by the unresponsive authorities as the deserved consequence of, in the case of sex workers, their work or, in the case of men who have sex with men, their sexual identity.
Injection drug users also face great stigma and ostracization.Because they use drugs, they too are portrayed as inherently "bad," though the abuse they face seems not to be specifically sexual.Injection drug users are beaten and subject to extortion by police and mastans, and needle exchange workers are sometimes arrested though rarely charged, all of which can have debilitating consequences for life-saving services.Farukh R., for example, told Human Rights Watch that prior to entering a rehabilitation program in December 2002, he regularly obtained clean needles from the CARE needle exchange program in Chapai Nawabganj.He said that after the arrest of a needle exchange worker in July 2002, he and other users were fearful and had a hard time locating needle exchange workers.Farukh R. said that as a result he shared needles with three to five other users for a period of about two weeks before he was able to reestablish regular contact with needle exchange workers.
These abuses-abductions, rapes, beatings, and extortion by police and mastans, arbitrary arrests and detentions, wider social discrimination-reflect the second-class status of sex workers, men who have sex with men, and injection drug users.The perpetuation of the abuses leads to even greater subordination.The abuses violate both Bangladeshi law and international human rights law, which are based on the inherent dignity and equality of all people.
Because sex workers, men who have sex with men, and injection drug users are so crucial to Bangladesh's fight against AIDS, the abuses have the additional consequence of reducing Bangladesh's capacity to curtail an emerging AIDS epidemic.HIV can be transmitted through rape.And even when rape is not part of the abuse, harassment of HIV/AIDS outreach workers directly interferes with efforts to disseminate information and build awareness of HIV and to distribute condoms and clean needles.More generally, the abuses faced by sex workers, men who have sex with men, and injection drug users further alienate these already marginalized persons from society and decrease the degree of control they have over their own lives.They become more difficult to reach with prevention and care information and services and they are in less of a position to protect their own health and the health of others.
Sex workers, men who have sex with men, and injection drug users experience an especially brutal manifestation of what are in fact nationwide problems in Bangladesh: violence and exploitation by police and mastans.Both civil society and, at certain points, the Bangladesh government have recognized that the police are widely corrupt and ineffective and that mastans wield a great deal of unchecked power over the general population.The predominance of mastan criminal activity and the police's inability or unwillingness to control it led the government to mobilize the army to fight domestic crime in late 2002.That mobilization, which the government called Operation Clean Heart, resulted in many serious human rights abuses, including the deaths in custody of at least forty people.The government has since immunized soldiers, police officers, and government officials from prosecution in the public courts for abuses that occurred during the campaign.Ultimately, Bangladesh must reform its law enforcement system to curtail the system's own abuses and to make it effective in protecting citizens' rights against mastans.
The plight of sex workers, men who have sex with men, and injection drug users lies, then, at the intersection of two great challenges for Bangladesh: its crisis of law and order and its struggle against the threat of a massive AIDS epidemic.In regard to both challenges, the situation of sex workers, men who have sex with men, and injection drug users also represents an opportunity.If Bangladesh can end police abuse of these groups and protect them from abuse by mastans, the nation will have made critical progress, both toward strengthening its fight against AIDS and toward creating an effective, rights-respecting law enforcement system.The nation also will have extended a measure of basic human dignity to people to whom dignity has been long and brutally denied.
 The names of witnesses have been changed for their protection.