The objectives of this review are to explore through a scoping analysis of published literature, the prevalence of suicidal ideation, attempts and suicide, and the correlates and presumed causes of such behaviours in Bangladesh, in order to develop a model of public health research and prevention. This type of review aims to contextualise existing knowledge, set it within a practice and policy context, and make recommendations for health care service delivery and evaluation. The evidence indicates an unusual pattern of completed suicide rates, those most at risk being younger women. The rate in adolescent girls is exceptionally high by international standards, and appears to reflect poverty, the low status of women, violence directed against girls and women, and forced marriages of young, teenage girls.
Background: This research is based on our argument that the commercial sexual exploitation of women and children (CSEWC) often includes a variety of abuses, sexual, physical, emotional, and economic. In Bangladesh, "Sex work" is a major industry, and about two percent of girls and women in the population aged 12 to 30 are subject to the status of CSEWC. Methods: From a review of literature and from ethnographic field work, we present an analysis of the sexual abuse of children, girls and women engaged in "sex work" in Bangladeshi brothels, addressing as well issues of STIs and HIV infection, in men who use CSEWC. Findings: Adolescents who are forced to become CSEWC suffer multiple forms of abuse, which may be life-threatening. Bangladeshi men of all ages and classes use CSEWC. Rates of HIV/AIDS remain relatively low (but may infect 5 percent in CSEWC). However, STIs (sexually transmitted infections) affect 50 percent of CSEWC, and at least 15 percent of men who use them. There is some evidence that men's widespread use of CSEWC spreads STIs to their wives, so that rates in women in the general population are relatively high. The CSEWC themselves suffer numerous physical and sexual abuses including bondage and trafficking to India and the Middle East. Police and local officials are involved in the toleration of this abuse, and about a third of money paid by men for sexual services passes to corrupt officials. Conclusions: We advocate support for the growing movement of adult women who campaign against the use of CSEWC, as a means of ending at least the exploitation of children and adolescents. We advocate also the development and evaluation of programmes of preventive education for high school students, as well as the reiteration of the norms of an Islamic culture which should end the sexual abuse of women and children. We also advocate the introduction of a basic income which would give women choices, How to cite this paper: Bagley, C., Kadri, S., Shahnaz, A., Simkhada, P., & King, K. 138enabling them to escape the life of CSEWC. Our final recommendation is for a major programme of research and evaluation of programme innovation which will describe the extent of, and ways of preventing, the commercial sexual exploitation of girls and women in Bangladesh.
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