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(IBBS) Surveys Among Vulnerable and Key Populations at Higher Risk in Bhutan, 2016

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(IBBS) Surveys Among Vulnerable and Key Populations at Higher Risk in Bhutan, 2016 Integrated Biological and Behavioral Surveillance (IBBS) Surveys among vulnerable and Key Populations at Higher Risk in Bhutan, 2016 Final Report September, 2016 Submitted by School of Planning Monitoring Evaluation and Research (SPMER), Kathmandu, Nepal i Contents Contents .................................................................................................................................................. ii ACKNOWLEDGEMENTS ......................................................................................................................... vii STUDY TEAM ........................................................................................................................................ viii EXECUTIVE SUMMARY ........................................................................................................................... ix Uniformed Personnel ................................................................................................................... xvii Transport workers ....................................................................................................................... xviii Migrant workers ............................................................................................................................ xix High risk women ........................................................................................................................... xix MSM/TG .........................................................................................................................................xx DU/PWIDs ..................................................................................................................................... xxi CHAPTER 1: INTRODUCTION .................................................................................................................. 1 1.1 Background ............................................................................................................................. 1 1.2 Objectives of the Survey: ........................................................................................................ 1 1.3 Rationale of the Survey ........................................................................................................... 2 1.4 Variables.................................................................................................................................. 3 CHAPTER 2: METHODOLOGY ................................................................................................................. 4 2.1 Implementation of the Survey ................................................................................................ 4 2.2 Survey Populations ................................................................................................................. 4 2.3 Survey Area ............................................................................................................................. 5 2.4 Study Design............................................................................................................................ 5 2.5 Sampling .................................................................................................................................. 5 2.6 Sample Size: ............................................................................................................................ 6 2.7 Data Collection Technique ...................................................................................................... 6 2.8 Identification and Recruitment process of KAPs .................................................................... 7 2.9 Recruitment and Refusals ....................................................................................................... 7 2.10 Control of Duplication ............................................................................................................. 7 2.11 Laboratory Procedures............................................................................................................ 7 2.12 Survey and Laboratory ID Codes ............................................................................................. 8 2.13 HIV Rapid Testing .................................................................................................................... 8 2.14 Syphilis Testing ........................................................................................................................ 9 2.15 Hepatitis B Rapid Testing ...................................................................................................... 10 2.16 Sample Transportation ......................................................................................................... 10 2.17 Internal and External Quality Assurance............................................................................... 10 2.18 Research Instrument ............................................................................................................. 10 2.19 Pre-Testing of Research Tools ............................................................................................... 10 2.20 Data Management and Analysis ........................................................................................... 11 2.21 Monitoring and Supervision .................................................................................................. 11 2.22 Ethical Consideration ............................................................................................................ 11 CHAPTER 3: RESULTS UNIFORMED PERSONNEL .................................................................................. 12 3.1 Socio-Demographic Characteristics of the Respondents ........................................................ 12 3.1.1 Sampled Districts: ................................................................................................................ 12 3.1.2 Duration of working in this profession: ........................................................................ 12 3.1.3 Demographic characteristics of respondents ............................................................... 13 3.2 Sexual Behavior ..................................................................................................................... 15 3.2.1 Sexual behavior with high risk women/drayang girls in Bhutan................................... 15 3.2.2 Sexual behavior with FSW outside Bhutan ................................................................... 17 3.3 Condom use .......................................................................................................................... 17 3.3.1 Condom use with wife (among married respondents) ................................................. 17 3.3.2 Condom use with high risk women in Bhutan .............................................................. 18 ii 3.3.3 Condom use with non-casual sex partners (girlfriend) in Bhutan ................................ 19 3.3.4 Condom use with female sex workers in Abroad ......................................................... 20 3.3.5 Condom use with male partner .................................................................................... 21 3.4 Condom accessibility ............................................................................................................. 21 3.5 Use of Alcohol and Drugs ...................................................................................................... 22 3.6 Sexually Transmitted Infection ............................................................................................. 23 3.6.1 Knowledge about STI .................................................................................................... 23 3.6.2 Symptoms of STI and treatment ................................................................................... 24 3.7 Awareness on HIV/AIDS & STIs ............................................................................................. 24 3.7.1 Awareness on HIV/AIDS & STIs ..................................................................................... 24 3.7.2 Comprehensive Knowledge on HIV ...................................................................................... 25 3.7.3 Information regarding HIV test ..................................................................................... 27 3.8 Stigma and discrimination .................................................................................................... 28 3.9 Reach by HIV/AIDS prevention intervention program .......................................................... 30 3.9.1 Peer-education; ............................................................................................................. 30 3.9.2 Visited DIC in the last 12 months .................................................................................. 30 3.9.3 Visited Health Information Service Centers (HISC) in the last 12 months .................... 31 3.10 Prevalence of HIV, Syphilis and Hepatitis B Virus ................................................................. 31 CHAPTER 4: RESULT TRANSPORT WORKERS ........................................................................................ 35 4.1 Socio-Demographic Characteristics of the Respondents ...................................................... 35 4.1.1 Sampled Districts: ......................................................................................................... 35 4.3 Use of condom .....................................................................................................................
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