Young People and HIV/AIDS Fact Sheet

Young People at the Centre of HIV/AIDS Epidemic

Young people aged 10-24 years constitute 32.5% of the The first few cases of AIDS in were reported in total population of Nepal and have been identified as 1988. Limited surveillance data in Nepal indicate that one of the groups most vulnerable to the growing HIV/ the current HIV prevalence is around 0.55% (FHI, AIDS pandemic1. The estimated HIV prevalence 2005). Until December 2005 the number of people NEPAL among young people (15-24 years) was 0.17% in males infected by HIV was 5 828. and 0.18% in females at the end of 20012. Ever reported Nepal, formerly considered a low prevalence country, HIV/AIDS cases at testing centres indicate that the has progressed into the category of a country with highest prevalence of HIV/AIDS is in the 20-29 years “concentrated epidemic” where HIV has age group (Table 1). increased significantly within the high-risk population like sex workers and injecting drug users (IDUs) Table 1: Cumulative HIV infection by (Table 2). HIV prevalence among female sex workers age group (1988 to 31 December 2005) increased from 0.7% in 1992 to 17% in 2002 and crossed Age group Male Female Total New 50% among IDUs nationwide3. (in years) Cases in December 2005 Table 2: HIV prevalence in high-risk groups High-risk groups Estimates 0-4 42 25 67 1 IDUs 52% 5-9 36 28 64 5 ( Valley, 2005) 10-14 24 10 34 1 SWs 15.6% 15-19 179 183 362 4 (Street based in KathmanduValley, 2002) 20-24 774 361 1 135 21 STI (2000) 0.7-6.6% 25-29 1 075 409 1 484 58 Blood donors 0.44% 30-39 1 633 428 2 061 70 (nationwide, 2002/2003) 40-49 411 116 527 17 ANC (2000) 0.2% 50 + 75 19 94 4 Source: National Centre for AIDS & STD Control, Ministry of Total 4 249 1 579 5 828 181 Health, Teku, Kathmandu, MoH, 2004-05 AIDS* 696 263 959 30 * Out of the total number of people living with HIV/AIDS : 286; new death cases in December 2005: 13 Source: National Centre for AIDS and STD Control, Teku, Kathmandu, MoH, Nepal, December 2005.

Young People Are Vulnerable to HIV & STIs

The major transmission route of HIV in the country is Family Planning Association of Nepal indicates that heterosexual where sexually transmitted though nearly a third of young people were aware of (STIs) form a significant part of the HIV epidemic. It is STIs, the knowledge on means of transmission and estimated that around 200 000 cases of STIs occur prevention was relatively low. The STI prevalence was annually in Nepal. A recent study conducted by the 5% among adults, 3% among adolescents and 6% in

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Nepal Option 2.pmd 1 11/22/2006, 12:56 PM 2 Nepal Option 2.pmd NEPAL Further, negotiatingforsafersexwiththeirhusbands compared tothemarriedboysinsameagegroup 19 yearagegroupwastwoandahalftimesmore 2001 Census,theproportionofmarriedgirlsin10- years arealreadymarried(Figure1).Accordingtothe women. Almosthalfofallyoungwomenaged15-19 undermines thehealthandwell-beingofyoung Early marriage,whichiscommoninNepal,further 1992 to3%in2001 has alsobeenshowingasteadyincreasefrom1%in Surveillance dataoncasesofHIVamongSTIpatients being illiterate of boysand51%girlsinthe10to19yearsagegroup younger agegroupareonlymarginallybetterwith26% age. Literacyratesandgenderdifferencesforthe over areliteratecomparedwith54%ofmenthesame in education.Only19%ofwomenaged15yearsand in SouthAsiaandlargegender-baseddifferencesexist and sexualnorms.Nepalhasthelowestliteracyrate limited accesstoeducationandfacerestrictivecultural vulnerable toHIV.Girlsandyoungwomenoftenhave in allspheresofsociallifemakingwomenmore in Nepalperpetuatedeep-rootedgenderinequalities Like mostculturesinSouthAsia,existingsocialnorms Girls andyoungwomen young womenaged20-24years women living withHIV/AIDSinNepalattheendof2003were One fourthoftheestimatedmorethan60000people Source: y18 by Married y15 by Married y20 by Married ea H 2001 DHS Nepal 7 . 0102030405060708090 iue1 g tmarriage at Age 1: Figure il 02 years 20-24 Girls 6 . Many YoungPeopleAreEspeciallyatHighRisk 5 . 19% 2 25% Percent il 52 years 25-29 Girls 4 . TheSentinel 60% 68% 76% 82% 8 . young people. ofsexuallytransmittedinfectionsamong commonly known,therebyleadingtoincreasing of condomsforeffectiveinfectionpreventionisnot In Nepal,accesstoSTDservicesispoorwhiletheuse fears thatthefigureisgrowing prevalence amongyoungsexworkersbutthereare were HIV-positive.ThereisnonationalstatisticforHIV as many70%ofsexworkersreturningfromIndia returned orwillreturntoNepal have beeninfectedwithHIVinIndiaandwho growing numbersofNepalesefemalesexworkerswho with high-riskbehaviourinNepaltherearealso increasing numberofHIVinfectionsamongpersons female sexworkersinbothcountries.Apartfromthe young NepalesemalesworkinginIndiafrequent Nepalese girlsaretraffickedtoIndiancitiesandmany Nepal’s HIV/AIDSvulnerability.Alargenumberof and prostitutionarethemajorcontributoryfactorsto , migration,conflict,traffickingofillicitdrugs Young sexworkers adopt safersexualpractices. and themeanstoprotectthemselvesornegotiate social normsdeprivegirlsoflifeskills,supportsystems girls andyoungwomenmoresusceptibletoHIV.Rigid Biological, socialandeconomicfactorstogethermake STIs. practice andinjectingdruguseatriskofHIVother Nepal, placingwivesofmenengagedinunsafesexual is notacommonpracticeamongmarriedwomenin sex workerswereHIV-positive in1996,thesurvey prevalence ofHIVinsexworkers. Whileonly2.7%of A surveyinKathmandu2000 revealedtheincreasing of thefemalesexworkerswereadolescents girls agedbetween10-19years.InJhapadistrict,31% sex workersrevealedthat59%ofthemwereyoung married womensellsex.AstudyinPokharaonfemale several girlsasyoung13yearsofageand towns, borderareasandhighways.Studiesshowthat Nepal, commercialsexworkisprevalentinmany Though, therearenoredlightareasorbrothelsin 11/22/2006, 12:56PM 9 . 3 . Itisestimatedthat 10 . Nepal Option 2.pmd relatively common,particularlywithinKathmandu Nepal revealthatsexbetweenmenseemstobe young menwhohavesexwith(MSM),studiesin Though noage-specificnationaldataisavailableon Young menwhohavesexwith(MSM) revealed thecorrespondingfigurestobe17.3%in2000 links withthewiderheterosexual population. population werehighlydiverse andincludedsexual revealed thatthesexual networksoftheMSM Assessing theriskbehaviouramongMSM,survey (Figure 2). revealed highprevalenceofSTIsamongthem 4.8% inMSWand3.6%MSM.Thesurveyalso between 16-24years)-showedanHIVprevalenceof Male SexWorkers-MSWand61%MSMwereaged majority ofthesamplerepresentingyoungMSM(59% USAID, CREHPA,SACTSandBDS–whichhadalarge Kathmandu ValleyconductedbyNCASC,FHI, An IntegratedBio-BehaviouralSurvey(IBBS)in risk ofbeinginfectedwithHIV. and areoftenmarried,puttingtheirspousesathigh They generallyidentifythemselvesasheterosexuals behaviour whenhavingsexwiththeirmalepartners. neither hastheknowledgenorpracticessafesexual positive inKathmandu.Thishiddencommunity 2005 revealed2%ofthetestedMSM(199)tobeHIV- The MonitoringtheAIDSPandemic(MAP)Report medical services. information aboutHIV/STIs,sexualhealthand female sexworkerslimittheiraccesstoaccurate Cultural, economicandsocialconstraintsofyoung

aly CS,FI SI,CEP,SCS&BS Nepal. BDS, & SACTS CREHPA, USAID, FHI, NCASC, Valley- Source: Percent I/T/S- mn S MSM & MSW among HIV/STI/HSV-2 10 20 30 40 50 60 70 80 0 nertdBoBhvorlSre IB nKathmandu in (IBBS Survey Bio-Behavioural Integrated 4.8 iue2 rvlnert of rate Prevalence 2: Figure I + HIV nKtmnuValley Kathmandu in 3.6 MSW 3 54 STI+ 19 MSM 28.9 HSV-2+ 8.4 5 5 . . use andIDUis17years.Behavioural researchamong Studies revealthattheaverage ageofinitiatingdrug the drughabit.(FHI/CREHPA,2001,2002,2003). of themreportedsmokingcigarettesastheentryinto practice, networkingandsexualbehaviour,almostall contacted foranin-depthstudyabouttheirinjecting a tenth(10%)inEasternTeraitobeadolescents.When IDUs inKathmandu,oneeighth(13%)Pokharaand Another studyfoundmorethanafifth(21%)ofthe Eastern Terairespectively(Figure4). 26.2%,4.3% and18.4%inKathmandu,Pokhra between 15-19years.TheHIVprevalencewas revealed highHIVprevalenceamongIDUsaged A studybyFHI,NewEraandSACTS(2002-2004) years old country’s 50000peopleinjectingdrugswere16-25 from 2%in1995tonearly50%1998.Halfofthe HIV prevalenceamongpeopleinjectingdrugssoared Young injectingdrugusers(IDUs) transmission tothegeneralpopulation. could beservingasa“bridginggroup”ofHIV unprotected sexualactivity.ItalsoindicatedthatMSM multiple sexualpartnershipsandhighlevelsof as anemerginggroupatriskofHIVbecausetheir The studyconcludedthatMSMshouldbeconsidered surveyed perceivedlittleornoriskofHIV(Figure3). It wasfoundthat55%oftheMSWand65%MSM sex partners,femalepartnersinparticular. Consistent condomusewaslowwithallcategoriesof

aly CS,FI SI,CEP,SCS&BS Nepal. BDS, & SACTS CREHPA, USAID, FHI, NCASC, Valley- Source: Percent 10 20 30 40 50 60 70 80 0 nertdBoBhvorlSre IB)i Kathmandu in (IBBS) Survey Bio-Behavioural Integrated 11 . iue3 xeto I risk HIV of Extent 3: Figure iteo orisk no or Little ecpinaogMSM among perception 55 11/22/2006, 12:56PM 65 MSW 28 oerisk Some 26 MSM 17 ihrisk High 9

3 NEPAL 4 Nepal Option 2.pmd NEPAL sexual partner’srisktoHIV regular aswellnonpartners,increasingtheir 20 yearsold.Consistentcondomusewaslowwith 78% hadtheirsexualdebutwhentheywerelessthan active andhadmultiplesexpartners.Approximately According toanotherstudy,youngIDUsweresexually regularly (FHI/CREHPA2003). in somecasesreportedgoingtodifferentgroups shared withtwoorthreemembersoftheirgroupand did sointheearlystagesofinjecting.Mostindividuals they didnotsharewithgroupmemberscurrently drugs withtheirgroup.Therestreportedthatthough Kathmandu saidthattheysharebothsyringesand nearly twothirdsoftheIDUs(4163)from major riskfactorforHIV,iscommon.Inonestudy, IDUs inNepalclearlyindicatesthatneedlesharing,a to 26%inEasternTerai,13% to21%inKathmandu IDUs withfemalesexworkers hadincreasedfrom22% It alsorevealedthatsexual contactofthesurveyed drugs atayoungerage(Figure5). that ahigherpercentageofIDUshadstartedinjecting second round(2005)findingsofthesurveyrevealed Comparisons betweenthefirstround(2002-03)and and 11.7%inWesterntoFarTerai. Valley, 31.6%inEasternTerai,21.7%PokharaValley places surveyed,withfiguresof51.7%inKathmandu years ofage.TheHIVprevalencewasveryhighinthe revealed thatmorethan40%ofIDUswerebelow25 conducted byNCASC,USAID,SACTSandFHI(2005) ValleyandWesterntoFarTerai 1 245IDUsinEasternTerai,KathmanduValley, An IntegratedBioBehaviouralStudy(IBBS)among

Source: Percent 10 20 30 40 50 60 70 80 0 H/NwEASCS2002-2004 ERA/SACTS New FHI/ iue4 I rvlneamong prevalence HIV 4: Figure Kathmandhu Dsi ea 2002-2004 Nepal in IDUs 68 I Alae)HV+(51 er old) years (15-19 + HIV ages) (All + HIV 22 4 35 Pokhra 5 . 26.2 atr Terai Eastern 4.3 18.4 these youngpeoplewithout adequateinformation, other countriesisalsoon an upswing.Migrationof search ofmeanssurvival inneighbouringIndiaand manipulated. Further,themobility ofyoungpeoplein STIs. Theyarealsoatriskofbeingrapedandsexually protection measuresagainstHIV,pregnancyandother there isshortageofinformationandservices,including In thetemporarysheltersthattheyhavetoputupin, young menandwomenatahighriskofSTIHIV. border. Displacementfromtheirplaceoforiginputs mostly young,bothinternallyaswellacrossthe decade whichforciblydisplacedthousandsofpeople, Nepal hasfacedprotractedpoliticalconflictforovera Conflict andyoungpeople from acommoncontainer. such assharingneedlesanddrugsolutions large numberofIDUswerestillatriskduetopractices had alsodeclinedinthepast12months(Figure6).A Consistent condomusewithdifferentsexualpartners and 33%to42%inPokharathepast12months. ihdfeetprnr nIU (2002-03-2005) IDUs in partners different with iue6 eln fcnitn odmuse condom consistent of Decline 6: Figure SIS AT n H,Npl 2005. Nepal, FHI, and SACTS USAIDS, Source: Percent 2005. Nepal, FHI, and SACTS USAIDS, Source: Percent 10 20 30 40 50 60 70 80 10 20 30 40 50 60 70 80 0 0 iue5 nraigpreto IDUs of percent Increasing 5: Figure eua (2002-03) Regular o eua (2005) regular Non netn rg tteae<0years <20 age the at drugs injecting nertdBoBhvorlSre IB) NCASC (IBBS), Survey Bio-Behavioural Integrated nertdBoBhvorlSre IB) NCASC (IBBS), Survey Bio-Behavioural Integrated 12 atr Terai Eastern atr Terai Eastern 11 46 28 11/22/2006, 12:56PM 24 51 41 2002-03 50 eua (2005) Regular S (2002-03) FSW 19 13 Kathmandu Kathmandu 45 48 35 54 53 2005 34 S (2005) FSW o eua (2002-03) regular Non 9 12 30 Pokhra Pokhra 40 64 60 50 68 Nepal Option 2.pmd involved incasualsex comparisonwiththeir of themarried,non-resident youngmen(46%)got worker astheirlastcasualpartner. Ahigherproportion resident youngmen(67%) citedacommercialsex sex withanon-regularpartner.Alargemajorityofnon- (40%) menintheagegroupof18-24yearsengaged young unmarriedresidents(54%)andnon-resident common and boyswithnon-regularpartnerswas revealed thatsexualactivityamongunmarriedgirls A surveyamongyoungfactoryworkersinKathmandu border townsofNepal resident youngmenwasfoundtobeprevalentinfive Sexually riskybehaviouramongresidentandnon- be attheriskofcontractingHIV. young factoryworkersdidnotperceivethemselvesto was thesameforbothboysandgirls.Amajorityof active. Themeanageofsexualdebutwas15yearsand of unmarriedgirlsaged14-19yearsweresexually drugs while5.4%injectedthem cases. Thesurveyalsoshowedthat13%hadtaken and 13%ingirlscausedpregnancy14%ofthe Unprotected sexledtoa22%STDinfectionrateinboys girls claimedthattheirpartnersusedcondoms. the boyssaidthattheyhadusedcondomwhile74%of the surveyweresexuallyactive.Two-thirds(65%)of in fiveboysandnearlyone10girlsinterviewed teenagers consideredpremaritalsexas‘proper’.One different districtsofNepalshowedthatalmost20% cultural ones.Asurveyof1400youngpeopleinseven gaps betweennewemergingnormsandexisting of marriage.Recentbehaviouraldataindicateswide between 15and16yearsoftenwithinthecontext The sexualdebutforthevastmajorityofgirlsoccurs Sexual activitybeginsearlyforyoungpeopleinNepal. Early initiationofsexualactivity support inordertofeedthemselvesandtheirchildren commercial sexintheabsenceofanyotherlivelihood home. Thesewomenarealsoatriskofpracticing family migrateleavingtheirwivesandchildrenback a higherriskofHIV.Insomecases,youngmeninthe skills andsupportinforeignlandsalsoplacesthemat 12 . Twentypercentofunmarriedboysand12% 5 Why YoungPeopleAreMoreVulnerable 5 . Asignificantproportionof 5 . commercial sexworkers. and only69%saidtheyshould nothavesexwith should usecondomstoprotect themselvesfromHIV about HIV/AIDS,only74%ofthemknewthatthey overwhelming majority(92%)ofteenagershadheard translate intosafesexualbehaviour the riskofHIV,thisawarenessdoesnotnecessarily though Nepaleseyoungpeoplearehighlyawareof A knowledge,attitudeandpracticesurveyrevealsthat its transmission(Figure7). of thisagegroupbelievedthattherewasawaytoavoid had heardofHIV/AIDSand44%women84%men age groupof20-24years,55%womenand87%men there wasawaytoavoidHIVtransmission.Forthe women surveyedand81%youngmenbelievedthat had heardofHIV/AIDS.Nearlyhalf(42%)allyoung and 52%youngwomenbetweentheagesof15-19years Health Surveyof2001,morethan86%youngmen UNFPA, 2005).AccordingtotheNepalDemographic different studies(UNAIDSandUNICEF,2001,VaRG/ found tobehighamongadolescentsandyouthin Knowledge onmodesoftransmissionHIVwasalso virus?” (MoH,Nepal,2002). when asked“Canahealthy-lookingpersonhaveAIDS women aged20-24yearsansweredintheaffirmative reported that82.6%of15-19yearoldwomenand80.8% youth ishigh.TheFamilyHealthSurveyof1996 awareness aboutHIV/AIDSamongadolescentsand A numberofstudiesconductedinNepalindicatethat Young peoplelackinformationandskills of livelihood. commercial sexinhotelsandrestaurantsasameans women displacedtothecitiesarepracticing also reportsthathaveshownanumberofyoung and thistooexposesthemtotheriskofHIV.Thereare and HIV. considered themselvestobeatriskofcontractingSTDs was generallylowandonlyasmallproportionofthem use ofcondomsduringsexwithnon-regularpartners unmarried, non-residentcounterparts(18%).Regular 11/22/2006, 12:56PM 13 . Althoughan

5 NEPAL 6 Nepal Option 2.pmd NEPAL adequate accesstoappropriateinformationand Existing dataindicatethatyoungpeopledonothave it withanypartner(Figure8). aware ofaplacetosourcecondoms,lessthan10%used While morethan95%of15-19yearoldmaleswere difference betweenthisknowledgeandcondomuse. people knowwheretogetcondoms,thereisamajor (2001) showsthatthoughalargemajorityofyoung Data fromtheNepalDemographicHealthSurvey and bloodsafety. discriminatory approach;confidentiality fortestresults, services forpeopleliving withHIV/AIDS;anon implemented programmes; coordination;evaluation; decentralized response;acknowledgementofNGO programmes; theneedformultisectoraland included prioritytoHIV/AIDSandSTDprevention prevention with12keypolicystatements.These In1995,NepaladoptedanationalpolicyforHIV/AIDS 1993-97. Control inNepalwasformulatedtocovertheyears Second MediumTermPlanforAIDSPreventionand the basisforFirstMediumTermPlan1990-92.The Term PlanforAIDSPreventionandControlformed of Nepalin1988.Thisprogramme,knownastheShort Programme waslaunchedbytheRoyalGovernment The firstNationalAIDSPreventionandControl aeheard Have vi HIV avoid fAIDS of hr sa is there Source: Believe a to way iue7 nweg bu HIV/AIDS about Knowledge 7: Figure ea H 2001 DHS Nepal 0102030405060708090100 Focusing ontheYoungtoHaltSpreadofHIV/AIDS 51 er (M) years 15-19 02 er (M) years 20-24 6 42.3 Percent 44.1 51 years(F) 15-19 years(F) 20-24 52.1 55.4 80.8 84.3 86.2 87.2 networks information throughinformalcommunication are unlikelytobeincorporatedintoorreceiveaccurate such asschoolsandhealthcaresystemsthanboys they havelessaccesstoformalinstitutionalstructures families. Girlsareinamorevulnerablepositionbecause reproductive healtharetopicsnotopenlydiscussedin Little sexeducationisofferedinschoolsand services aboutsexualandreproductivehealthissues. thereby optimizingprevention andreducingthesocial do thisbyfocusingonactivities withinpriorityareas, and increasetheeffectiveness oftheresponse.Itwill number ofpartnersinvolved inthenationalresponse The visionoftheNationalStrategyistoexpand is tocontaintheHIV/AIDSepidemicincountry. The overallobjectiveofNepal’sstrategyforHIV/AIDS Prime Minister. established a“NationalAIDSCouncil”chairedbythe activities foreachpolicyobjective.RecentlyNepalalso operationalize thenationalpolicyanddefinekey to 2001wasdevelopedandadopted.Ittried Plan forHIVandAIDSinNepal”theperiod1997 programme. BasedontheNationalPolicy,a“Strategic implementation oftheHIV/AIDSprevention formed withinthedepartmentofhealthfor The NationalCentreforAIDSandSTDControlwas cohabiting s with Use partner s with Use nwa Know Source partner source any ea H 2001 DHS Nepal : 6 0102030405060708090100 . oreadueo condoms of use and source 6.6 7.4 iue8 nweg of Knowledge 8: Figure 7.7 9.2 11/22/2006, 12:56PM 02 er (M) years 20-24 51 years(M) 15-19 Percent 02 er (F) years 20-24 51 er (F) years 15-19 67.3 78.2 91.5 95.1 Nepal Option 2.pmd • • • • • • Strategies young people’sneedsandbehaviouralpatterns. decision-makers atalllevelsandcommunitiesabout young peoplebyincreasingtheunderstandingamong a supportiveenvironmentforbehaviourchangeamong and communityenvironment.Theobjectiveistocreate The focusherewillbeoncreatingasupportivepolicy new infectionsamongyoungpeople. of STIandHIVinfectionamongvulnerablegroups epidemic inNepal.Priorityareasincludetheprevention been designedtoguidetheexpandedresponse Nepal’s NationalHIV/AIDSStrategy2002-2006has health servicestoyoungpeople. increase accessandutilizationofadolescentfriendly adolescent-related issues.Thebasicstrategyaimsto Health andDevelopmentStrategyinordertoaddress In 2000NepalalsoadoptedtheNationalAdolescent impact ofHIV/AIDSinthemostcost-effectivemanner. formal educationsettings. AIDS andmethodsofprevention informalandnon- and sexuality. emphasis oninformationaboutreproductivehealth youth friendlyandgendersensitiveserviceswithan of increasingtheaccessibilityandavailability infections. how toavoidHIVandsexuallytransmitted young peoplewiththeknowledgeandlifeskillson communication withtheobjectiveofempowering determinants ofyoungpeople’sbehaviour. parents andcommunities. with focusonpolicy-makers,decision-makers, and programmingaffectingyoungpeople. sectors, CBOsandyoungpeopleonpolicy-making unions, educationalandsupportinstitutions,private between ministries,localauthorities,NGOs,trade Enhancing youngpeople’sknowledgeaboutHIV/ Providing youthfriendlyserviceswiththeobjective Promoting awarenessandbehaviourchange To conductqualitativeresearchaboutthe Advocacy fortheneedsandrightsofyoungpeople Establishment ofamechanismforjointconsultation 7 Nepal. Anintegratedreproductive healthand voluntary counsellingand testing,intwodistricts includes providinginformationandservices,including comprehensive packagetoyoungpeople.This AIDS inNepal’hasinitiatedtheprocesstodelivera ‘Youth FriendlyServicestopreventSRHandHIV/ services inthedistricts,UNFPAthroughUBW there areveryfewadolescentandyouthfriendlyhealth developing policiesandprogrammesforyouth.As of HealthandPopulationisintheprocess Youth SectionhasbeenestablishedwithintheMinistry young people,hasbeenlimited.AnAdolescentand The responsetoHIV/AIDSinNepal,especiallyfor (NCASC, MOH,2003). partners toincreaseeffectivenessoftheresponse of thespreadHIV/AIDSby2005”workingwith mission statementofthisplanisto“beginthereverse Control 2003-2007hasalsobeendeveloped.The of 2002-2006.NationalOperationalPlanforHIV/AIDS in the10 HIV/AIDS hasbeenincludedasoneofthemainissues Zonal HospitalandBPKHSDharan. available inthreehospitals:MaternityHospital,Bheri -to-child transmission(PMTCT)programmeis on ARVtreatment(CEPRA,2005).Preventionof Chem. Currently,atotalof316HIV/AIDScasesare Nepal, SPARSHA,BlueDiamondSociety,andYeti private serviceproviderssuchasNavaKiranPlus,Maiti Nepalgunj, andBPKHS,Dharan,fewNGOs hospitals: TEKUHospital,Bheri,Zonal Antiretroviral treatmentisbeingprovidedfromthree and STDControl. and reportedregularlytotheNationalCentreforAIDS and testingservicesarebeingprovidedfrom50sites, literature areyouth-targeted.Voluntarycounselling distribution ofbooklets,brochuresandsimilar newspapers, trainingprogrammesandworkshops communication programmesthroughtelevision,radio, other groups.Information,educationand schoolchildren, collegestudents,schooldropoutsand activities areunderwaywithparticularfocuson for HIVprevention.Variousawareness-raising identified youngpeopleasoneofthehigh-riskgroups The NationalHIV/AIDSStrategyofNepalhas th DevelopmentPlanwhichcoverstheperiod 11/22/2006, 12:56PM

7 NEPAL 8 Nepal Option 2.pmd NEPAL in thecountryare:WHO,UNICEF,NepalRedCross other organizationsworkingonHIVandyoungpeople Initiative forYoungPeopleinAsiaNepal.Amongthe in 19districtsthroughtheReproductiveHealth information serviceisbeingprovidedtoyoungpeople .Mathur,Sanyukta;Mehta,Manisha;Malhotra,Anju. 6. References 12.Puri M. 12.Puri 11. 13. HealthDivision,MinistryofHealth. 10.Family 9. 8. 7. 5. 4. 3. 2. CentralBureauofStatistics. 1. International CentreforResearchonWomen,2004.(Accessed1Sept2006: in Nepal Young peopleandHIV/AIDS:opportunityincrisis A surveyofteenagersinNepalforlifeskillsdevelopmentandHIV/AIDS prevention. ehrxlfgbyfcg2k4ma7wdekizqooo5styhdsfi4o53xz6yzfxjpkqperclhwzo6bvqcfnmc6ar4lxqf/STDfactoryworkers1.pdf ). uploads/publication/20060111035142.pdf ). Nepal’s NationalHIV/AIDSstrategy2002-2006 Population MonographofNepalVol.II ). / nationalestimatesadulthivnepal2003no.pdf http://www.fhi.org/NR/rdonlyres/en7dr3ytcz4v7zo4aogyh23kpj4vzmiokbzusdt2khr4b2mgzzislju53quawsi2 67m7dfm6xxhkfd National estimatesofadultHIVinfectionsNepal2003 nepal_0104.pdf#search=’Youth%20reproductive%20health%20in%20Nepal%3A%20is%20participation%20the%20answer’ Sept 2006: The HIV/AIDS/STDsituationandthenationalresponseinNepal:countryprofile September 2005. Nepal projectdocument:regionalworkshoponmodelsforscaling-upyouthfriendlyservicesSRH&HIVpreventioninSouthAsia 2004. (September 2005):reportbytheSecretariat. Health-related MillenniumDevelopmentGoals:updateafterthehigh-levelplenarymeetingofUnitedNationsGeneralAssembl Epidemiological factsheetsonHIV/AIDSandsexuallytransmittedinfections-Nepal,2004updated . Kathmandu:CREHPA,2001.(Accessed1Sept2006: Sexual riskbehaviourandperceptionofunwantedpregnancies sexuallytransmitteddiseasesamongyoungfactoryworkers http://www.unaids.org.np/uploads/publication/20060108133717.pdf ). http://www.unaids.org.np/uploads/publication/20060108133717.pdf : Kathmandu:UNFPACSTforSouth&WestAsia,2005. 8 Miscellaneous publicationsheets,2001Censusdata . Kathmandu:CentralBureauofStatistics,2003. EB 117. . Kathmandu:UNAIDS,2003.(Accessed1Sept2006: Adolescent healthanddevelopmentinNepal–Acountryprofile2005 . Geneva:WHO/UNICEFUNAIDS,2002.

Geneva: WorldHealthOrganization,2006 . Kathmandu:NCASC,MinistryofHealth,2004.(Accessed1Sept2006: Youth reproductivehealthinNepal:isparticipationtheanswer? http://www.fhi.org/NR/rdonlyres/ Foundation. CARE NepalandtheBritishMedical and ReliefAgency[ADRA],SavetheChildrenUS, RHIYA NGOs,SOLIDNepal,AdventistDevelopment Society, FamilyPlanningAssociationofNepal[FPAN], http://www.icrw.org/docs/ . Kathmandu,2002. . Kathmandu:UNAIDS,NCASC,2004.(Accessed1 Kathmandu:UNAIDS,2001. 11/22/2006, 12:56PM . . Geneva:UNAIDS,UNICEF,WHO, http://www.unaids.org.np/ . Kathmandu,2005. Washington: y , 12-13 ) .