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Nepal's vulnerability to HIV/AIDS is fueled by
poverty, gender inequalities, low levels of education and literacy, denial,
stigma, and discrimination. Though the absolute number of HIV/AIDS cases is
still low, there are already "concentrated" epidemics within certain
high-risk behavior groups in Nepal. Immediate and vigorous action must be
taken now to prevent further spread of HIV among groups at high risk and stop
the infection from taking a foothold in the larger population.
The first case of AIDS in Nepal was reported in 1988. As of December 2001,
UNAIDS estimated that 38,000 people were living with HIV/AIDS, and 3,500 AIDS-related
deaths had occurred. As of March 2002, MOH reported 585 AIDS cases and 2243
HIV positives.
Nepal has entered the stage of a "concentrated epidemic" with HIV/AIDS
prevalence constantly exceeding 5 percent in one or more high-risk groups,
such as sex workers and injecting drug users.
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Risk factors that put Nepal in danger of experiencing a widespread epidemic
if immediate and vigorous action is not taken: |
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Injecting Drug Users:
In most Asian countries, injecting drug users (IDUs) are the first
community to be affected by HIV. With HIV prevalence of 20 percent, an estimated
20,000 IDUs in Nepal are at great risk of contracting HIV.
Commercial
Sex Industry:
Nepal runs the risk
of an increased epidemic due to an active sex trade and high rates of girl
trafficking to India for sex work. It is estimated that approximately 100,000
Nepalese are engaged in commercial sex work in India.
Young
People:
Increasing vulnerability of young people is mainly due to a widening generational
and cultural gap between adolescents and the older generation. In many cases,
even if girls and women have knowledge of STDs and AIDS their access to protection
is restricted as a result of their lower status.
Migration
and Mobility:
Seasonal and long-term
labor migration to neighboring countries, such as India, is necessary for
the economic survival of many households in both rural and urban areas. Thousands
of women and men live away from their families as migrant workers. Removal
from traditional social structures, such as family, has been shown to promote
unsafe sexual practices, such as engaging in multiple sexual partners and
in commercial sex. Migrants who return from India carrying the virus with
them. It is estimated that as many as 70 percent of SW returning from India
are HIV-positive.
Thus young people are the center of HIV/AIDS and HIV/AIDS is a dominant health
issue that presently needs immediate attention in Nepal. By the end of 1998,
there were altogether 1,189 HIV infected persons in Nepal, indicated by NCASC.
The number has been increasing and as shown by NCASC, by the end of March
31, 2002 the total number of HIV infected people was 2,243.
People living with HIV/AIDS (PLWHA) have the right to live a dignified life,
and whether this is possible or not is dependent upon many social, political,
and economic factors.
Youth for Change, Nepal endeavors to address
the issue of HIV/AIDS and PLWHA through the following actions.
* Rights-based advocacy movements, which
try to represent the issue of female sex workers, HIV infected people, and
other affected people.
* Provide information to young people
through life skills and health and sexually educations in schools.
* Life skills based peer education to
prevent HIV/AIDS.
* Establish youth-focused Voluntary counseling
and testing (VCT) for HIV/AIDS and rehabilitation centers
* Cooperating with the government and
pressurize government bodies to act on behalf of the infected and affected
group
* Provide health services to young people
through subsidized social marketing of condoms.
* Creating a strong networking environment.
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