AIDS a real threat for Nepal

RENU KSHETRY

KATHMANDU, Dec 1 - Some 30,000 female sex workers (FSW) were engaged in sexual activities with 600,000 male clients in Nepal in 2007, making for a ratio of 1:20 (FSW: client), according to National Estimates of HIV Infections, Nepal. The ratio is comparatively higher than the average ...

"It is high time the government legalised prostitution. It would help control the HIV epidemic through effective preventive measures," said Rajiv Kafle, president of National Association of People living with HIV/ AIDS.

Kafle said sex workers were not taking preventive measures because they feared police would harass them if contraceptives were found during raids where sexual activities take place.

According to NCASC, recent estimates show that 41 percent of all HIV cases in Nepal are among seasonal labour migrants, 16 percent among clients of sex workers, while 21 percent are wives or partners of HIV-positive men.

A huge gap between reported cases and estimated cases makes achieving one of the Millennium Development Goals, that of halting and reversing the spread of HIV/AIDS by 2015, a far-fetched dream.

Some 12,000 HIV and AIDS cases have been reported till date while the national estimation is around 70,000, according to NCASC.

Vice-Chair of HASCB, Dr Sarad Onta, said FSWs, clients of sex workers and Injecting Drug Users (IDU) were transmitting HIV to their partners. "It is turning into a 'silent emergency,'" said Dr Onta.

According to NCASC, 5,643 clients of Sex workers (SWS), 770 SWs and 2,918 housewives are reported to be infected with HIV till Sept. 2008.

The government has identified the people likely to get HIV. They are FSWs, IDUs, Man having sex with Man (MSM), client of sex workers and migrant workers.

"If we could concentrate on preventive efforts to reduce HIV transmission among these most-at-risk populations, the epidemic might be brought under control," said Dr Onta. "Apart from treating the HIV patients, the Health Ministry is coordinating with other line ministries to make programmes on HIV and AIDs more effective.

Dr Sashi Sharma, Chief of HIV/AIDS Committee at Tribhuvan University Teaching Hospital, said that there is a need to expand and strengthen the voluntary testing counselling centres throughout the country to dig out the hidden cases.

There are 133 Volunatary Counselling Testing (VCTs) centres and 23 Anti-retroviral therapy (ART) sites across the country.

Kafle said there was a need to introduce provider initiative testing mechanism in which the physician would include HIV testing as a part of regular testing rather than that of voluntary testing. "The initiative will help identify the cases which eventually will be helpful in preventive care and treatment," said Kafle.