Background The HIV prevalence in Bangladesh is still low with < 0.1% in general population and < 1% in most at risk populations (MARPs) though all the risk factors prevail like unsafe injecting practises and sex work, low condom use, taboos, social denial, illiteracy and a lack of awareness. With grants from the Global Fund, Save the Children has doubled the national coverage for people who inject drugs (PWID) and female sex workers (FSWs). Nearly 13,500 PWID and 29,000 FSWs are under the programme coverage.

Methods Save the Children provides essential services for PWID through 69 drop in centres (DICs) and for FSWs through 100 DICs and 10 outreach offices in 53 districts. The DICs provides them with sterile needle-syringe, access to detoxification, abscess management, condoms, STI services, general health services, referrals and information including bathing, resting and recreational facilities. Over 23 million needle/syringe and 3.5 million condoms for PWID and 55 million condoms for FSWs are distributed. The programme also provides information and services through a multi-level multi-channel approach to the general and vulnerable youth.

Results The percentage of PWID using sterile injecting equipment increased from 39% (Baseline Survey, 2008) to 92% in 2012 (Mid Term Survey, 2012). PWID using condom during the most recent sexual contact with a FSWs within last 12 months increased from 39% to 75.4%. FSWs using condom during the most recent sexual contact increased from 63% to 95.5%. Young people aged 15–24 (potential clients of FSWs and vulnerable to drugs), who correctly identified at least two ways of preventing HIV, increased from 40.8% (Baseline Survey, 2005) to 81.7%.

Conclusion The programme contributed a lot to bring positive behaviour changes in PWID and FSWs. Further expansion and scale up will enable them for safer practises that will help the country retaining the low HIV prevalence.