HIV and AIDS Program- Migrants and their Spouses
Both internal and international short and long term migration of young men, including seasonal labour migration, is becoming increasingly common and occurs regularly from districts of Far West, Terai and hilly regions, to mostly the urban areas of Nepal, India and other countries of the Persian Gulf and Southeast Asia. This phenomenon has programmatic implications as reaching migrants across the border is a complex and challenging task.
Integrated Bio-Behavioral Survey data show that 67.8% of young males in the West and 57.9% in the Mid-Far West migrate before the age of 20. Recent data also show that around 20% of migrants engage in unprotected sex in India (never used condoms with FSWs in the past year) and as a result, this group now accounts for 40% of all HIV infections in Nepal with numbers of HIV cases also increasing among wives and partners. Improvements in strategies to prevent secondary transmission from infected migrants are crucial.
HIV prevalence of migrants has remained relatively low in 1.4% (West) and 0.8% (Far West), although prevalence in wives of migrants is 3.3%. The prevention coverage is the lowest among all key populations, both for migrants and their wives. Comprehensive knowledge and condom use are also not very high compared to other MARPS. So, the programme ‘s need is reaching migrants in the districts with high migration or high transit districts.
Migrants alone accounted for about 30% of HIV infections. Moreover, labour migrants are also considered to be at higher risk of HIV as a significant proportion of this population have unprotected sex with multiple partners when they are abroad. It is notable that migrants, remaining male and remaining female sub-population groups have contributed the majority in the total estimated number of HIV infection (prevalence pool). This is due to their disproportionately bigger population sizes, in contrast to that of the MARPs. However, the main drivers of the epidemics are, in fact, the MARPs including migrants and clients of sex workers due to their high level of HIV prevalence and behavioral factors that are associated with and contributed to HIV transmission.
To ensure that migrant workers who are most at risk be provided with prevention, care and support programs.
2008 migrants, 2700 their spouses and 130 PLHIV from 15 VDCs and 1 Municipality of Ramechhap district.