Reducing provider-held stigma and improving client satisfaction in Bangladesh: Results from a Link Up evaluation

M AY 2 01 6 In Bangladesh, HIV prevalence has been estimated to be less than one percent in the general population, however, sex workers, men who have sex with men (MSM), and transgender people are disproportionately affected.1,2 Research in Bangladesh has documented high levels of discrimination by health service providers toward people living with HIV3,4 and avoidance of health services by people living with HIV due to fear of potential discrimination from providers.5 Stigma can inhibit uptake of critical HIV and sexual and reproductive health and rights (SRHR) services, particularly among young people.6 Stigma has been associated with lower rates of HIV-related knowledge, testing, disclosure, social support, physical health, mental health, and adherence to antiretroviral treatment.7-9 Furthermore, research in Bangladesh has documented stigma (unrelated to HIV) among healthcare providers toward sex workers10, MSM11, and transgender people (called “hijra” in Bangladesh)12, which inhibits disclosure of important health-related information to providers.