title: Profile of an HIV Testing and Counseling Unit in Bangladesh: Majority of New Diagnoses among Returning Migrant Workers and Spouses.
abstract: BACKGROUND
  Analysis of data from HIV testing and counseling (HTC) services provides an opportunity to identify important populations for targeting of HIV prevention efforts. Our primary aim was to describe the demographics of clients presenting to HTC in Bangladesh, a low HIV prevalence country. Our secondary aim was to determine the risk factors for HIV positivity among returning migrant workers who were tested.
  
  
  METHODS
  We performed a cross-sectional study of data collected between 2002 and 2010 from the first HTC service established in Bangladesh, located in three large cities.
  
  
  RESULTS
  8973 individuals attended HTC services, with 558 (6.2%) of clients testing positive for HIV, including 33 children. The majority of those who tested positive were aged 25-44 (71%), male (70%), and married (68%). Key populations considered at increased risk of HIV, such as female sex workers, people who inject drugs, and males who have sex with males accounted for only 11% of adults who tested positive. Notably, 75% of adults testing positive had a history of migrant work or was the spouse of a migrant worker. In multivariable logistic regression of those with a migrant work history presenting for HTC, we found rural residence, working in the Middle East, and longer duration of migrant work to be independently associated with testing positive, and female gender and higher level of education to be negatively associated.
  
  
  CONCLUSIONS
  These data suggest that in Bangladesh, in addition to targeting traditional key populations, HIV prevention efforts should also focus on migrant workers and their spouses.
authors.affiliation: Centre for HIV/AIDS, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; Hospitals, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Arunthia Zaidi
authors.initials: AZ
authors.lastname: Urmi
authors.affiliation: Centre for HIV/AIDS, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; Centre for Vaccine Sciences, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Leung
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Wilkinson
authors.affiliation: Centre for HIV/AIDS, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; Hospitals, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Mohammad Abdul Awal
authors.initials: MA
authors.lastname: Miah
authors.affiliation: Centre for HIV/AIDS, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; Hospitals, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Mahfuza
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Centre for HIV/AIDS, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Tasnim
authors.initials: T
authors.lastname: Azim
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001459:Bangladesh; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests / Q000706:statistics & numerical data*; D018454:Spouses / Q000706:statistics & numerical data; D014171:Transients and Migrants / Q000706:statistics & numerical data*