Was going through this page... its really scary ... anyone involved in AIDS prevention .. can you please put light on this please...

http://www.youandaids.org/Asia%20Pacific%20at%20a%20Glance/Nepal/index.asp

The Potential for a Rapid Increase in HIV Prevalence

Behavioural and sero-prevalence data indicate the high potential for a generalised epidemic in Nepal. In the absence of effective interventions, even a "low to moderate growth scenario" would make AIDS the leading cause of death in the 15-49 year old population over the coming years. For Nepal, this would mean that around 100,000-200,000 young adults will become infected and that overall 10,000-15,000 annual AIDS cases and deaths due to related illnesses may be expected.

The following table shows three scenarios: a "low-stable" scenario, with the sero-prevalence levelling off at 0.5% in 2005; a "low-moderate growth" estimate with a prevalence rate of 1% in three years time; and finally a "moderate growth" model, reaching 1.6% in 2005. The difference between the three scenarios is the actual gain in lives, provided that the response to the epidemic in Nepal is effective enough to impact on the development of the epidemic.

it sure is scary!!!!

it seems hardly anyone is interested in social/economical problem of nepal... we spend days talking about KG, Girija, Prachanda than being serious of "high potential for a generalised epidemic" ... lets create some kind of awareness... this thing is projected to take 10,000~20,000 lives in one year....... far more than 13,000 lives taken by current political crisis in 10 yrs... some sajha members should have been involved in AIDS prevention.... lets share ... there must be some root cause of this problem.. most of us just blame to Mumbai prostitutes, Drug abusers... but are they the root cause? is government the only body who should be kept sole responsible? please lets share...we can make difference

When someone is infected with HIV, they do not have to progress to AIDS to develop symptoms. There is a known Acute Retroviral Syndrome that presents with many of the symptoms you are describing (fever, malaise, sore throat, nausea/vomiting). This is found in 50-70% of HIV infected individuals, and generally occurs 3-6 weeks after infection. The symptoms generally last anywhere from 1 week - 3 months.

If you are a known to have been exposed to Hepatitis B, many of the same symptoms can be associated with an acute flare of the disease. In any event, seeing a doctor is critical, as early intervention with medication can prevent or delay many of the long-term effects of these diseases.

Seriously I would suggest everyone(married & unmarried) should get tested on HIV/STDS every other year....but too bad that people think they dont need it...

web009,

I worked for HIV/AIDS prevention in Nepal as a student during my summer break when I was in Kathmandu for holidays...the situation then was dire and now it has just gotten far worse.

As far as the reasons for the alarming rate of infections is concerned, there are several:
Yes Prostitution (also known as "commercial sex workers") is one of the main reasons for the rise. with regards to Prostitution, women who have been sold to brothels in India and now to various Cabin bar and dance restaurants that littler Thamel are often not allowed to use protection- In Bombay, girls are severely and brutally punished for even asking and it is not unknown that there are several extremely sick people who will leave infected Nepali girls from Indian brothels at the border with Nepal so that Nepal can deal with them

Secondly, the Peace keeping force is another very high risk population. There was a time when the Nepal Government gave zero training to Army personnel before shiping them out for peace keeping missions as a result of which several army folks contracted infections while abroad. A Nepali NGO called Women's Inspiration Community based in KTM, was the first and only group that was allowed access to the Army, Police and even the three prisons in KTM (Central Jail, Bhadragol (spelling?) and Mahila Jail) to conduct HIV/AIDS awareness/prevention and support programs at these places.

Business men from Nepal who frequently travelabroad are another very high risk population: They go on "business" trips, hire prostitutes, get infected and knowingly or unknowingly come back home to wife, infect her and sometimes the unborn child--this has happened time and time again in Nepal.

Intravenous (I.V) Drug Users, an alarmingly high demographic in Nepal are perhaps the higest risk group. "Life Saving and Life Giving" (LALS), another NGO was the only entity in Nepal that I know of that had a needle exchange program where they actively distributed needles to high risk populations.

LALS and WICom also started "Prerna", the support group for Nepalese living with HIV/AIDS.

Now for the things that need to be done:....where do I start?

Government: There is and has always been an utter lack of understanding by the government on the risk of HIV/AIDS pandemic in Nepal. To the best of my knowledge, the Social Welfare Council for years was in the control of the Palace and even though AIDS was already a problem in Nepal, no one paid attention to it. It took AMFAR(American Foundation for Aids Research) comming into Nepal shortly after democracy to get NGO's started to enable them to work on the issue.
The government needs to have stiffer penalties for human traffickers, penalties for Indian brother owners who leave infected, helpless women on the borders and start taking notice of the epidemic and pass legislation accordingly.

Medical Personnel: I can't tell you about the number of times I have been to the prison/army barracks and homes of people in Nepal when I was working with WICom to take them to the doctor only to have them refuse treatment becuase the patient was HIV positive. There needs to be training as well as penalties imposed against medical personnel in Nepal who refuse treatment just becuase someone is HIV positive.

Students/people in general: The prejudice that the general Nepali has about AIDS is so strong that they are not willing to help. As long as they are not infected and don't know of someone who is infected..what do they care?...it's the attitude that needs to get changed and that is going to take years to do.

Let me know if you need additional information, I am only too glad to help in any way I can.

When HIV women give birth to a child what do they do there? Cause lets not forget breast milk, since children (particularly in the third world) rely on breast milk for a long time. It's really a conundrum for HIV-positive mothers: without breast milk their baby would probably die. Transmission rates from mother-to-child is about 20% through natural child birth (without treatment).

But with treatment and a C-section the rate is something like 1%.......

thats great information by ladyinred and Nepaali.. thanks .. Nepaali ,its really nice to find out you seemed to have spend lots of time working for this cause, ... i didn't knew that Peace Mission was 2nd biggest cause of HIV and AIDS in nepal... lets all of us discuss of real problem which is creating this epidemic... and we can further discuss how this epidemic can be control( i have heard Thailand is doing very good in AIDS control and same with some African countries) can their method be used in nepal? if they can control why can't we?

as you mentioned.. we (society) are creating an atmosphere to let AIDS go beyond our control.... we are closing our eyes and running away from the problem... lets face it and give some of our time and try to find some solution.. Pleae share

FHI (Family Health International) which subcontracts grants from USAID has been actively working in prevention and treatment of STI (Sexually Transmitted Infections)in Nepal.It subcontracts work to AMDA,GWP,LALS and couple of other organizations for awareness,prevention,treatment and rehabilitation of STI infected population.
The socio economic factor coupled with lack of education and awareness in South Asian countries has been the biggest hurdle in fighting AIDS.

thanks Laura,i... it seems lots of NGOs are working on AIDS, but look at the graph... its growing like crazy.. does it mean that if these NGO's weren't there things would have been much worst? wow big applause to them.. Thailand was doing condom promotion to fight STD, does Nepal have such plans... are people infected with HIV/AIDS(returning from Mumbai) in some productive work? i.e. manufacturing handicraft,gifts item etc .. so next time we buy gifts for friends abroad we can buy those goods so theyare encouraged to lead respectable social life, rather than go back to same life... please share...

web009,
The fact that there a lot of NGO's in Nepal is not necessarily indicative of the work they do i.e...when AMfAR came to Nepal, it started a mushrooming of NGO's; some of them like WICom, LALS, B.P Memorial Fund (a buch of doctors that worked to raise awareness of the epidemic) and several others did brilliant work in Nepal but not all NGO's were able to or perhaps willing to perform...and that's something that we need to be honest about and take into consideration in any scheme that is geared towards arresting the spread of HIV/AIDS in Nepal.

As far as services for women returning from brothels is concerned, there are some NGO's that have rehabilative programs- Maiti Nepal being one that has gained internatioal recognition for the work that ANuradha Koirala does with these young ladies, but, that is not enough..it should not be up to the International Agencies to provide funds for everything-surely the government of Nepal has some responsibility to create job training programs as a means of rehabilitation (the same is true for maoist rebels as well)

As far as condom distribution is concerned, I know that WICom had a directed program of safe sex at the prisons (yes, people male prisoners in Nepal have sex--get over the shock!) as well as with the armed forces so they had boxes made that we would fill with condoms and leave at the barracks and the jail..we would then recieve phone calls from army guys or prisoners saying in very shy voices that we needed to re-fill them :-)

The social scene in Nepal has changed rapidly in recent years and while it is a known fact that Nepali youth are increasingly starting to form sexual relationships earlier than in prior years, to the best of my knowledge, no school, high school or even college has anything that even resembles a safe sex program..the silence is doing more harm than good and that needs to change soon if the country has any hope of stopping a pandemic amongst the youth.

I look forward to other Sajhaites contributions on this thread.

I agree with Nepaali.
As I mentioned above, the socio economic factor coupled with lack of awareness and education is the biggest hurdle.
-The people (like counsellor,peer educators,facilitator,medical personnel etc) who have direct access to the target client do not want to be seen with them in public.
-Couples/parents are scared to ask medical records.
-AIDS which is no longer a protitute disease cannot be spoken aloud.
-Prostitutes have greater bargaining power than housewives regarding safe sex because they can kick out the client but a wife can't kick their husband.
-Total apathy on the government side regarding this looming danger.

Thanks Nepaali, I really didn't knew about Armed forces and Jail issues, where as i had once heard there is huge amount of homosexual prisoners,

you are right Laura, prostitutes can kick out their client but wives can't... that's pity ...

Nepaali... as you said....the silence is doing more harm than good and that needs to change soon if the country has any hope of stopping a pandemic amongst the youth... and it seems our fellow Sajhaites are also silent ....
I also look forward to other Sajhaites contributions on this thread. .... please share... this is really a very serious issue...

web009,
thanx for bringing forth a very important issue that we've failed to deem it as important in our society. The statistics are absolutely staggering.

What is also interesting that the younger generation in cities like KTM, who claim to have brought a sexual revolution, in urban areas are equally vulnerable. In a society like ours, where talking bout sex is a taboo, the practice of safe sex is a distant myth. The opening of beauty parlors and cabin restaurants that have mushroomed all over the cities haven't helped this cause, but even medical students who are on a HIGH enjoying freedom away from their home do not acknowledge the importance of safe sex or/and are not comfortable going to a pharmacy to get a protection. That to me was shocking!

I guess its high time that we all realize the importance of sex education in schools & homes!

hi oys_chill,sexual revolution i found among current youth.... is plain "sex" .with little or no knowledge of the consequences. they don't care about STD or pregnancy... there was a report in Nepal saying almost 50% of +2 students have had sex atleast once, which was no way the case 10 yrs back. this is no way helping control HIV.
are we, as society failing to stop this? or schools aren't doing their job? we send our children so they can learn and keeping them aware is these issues is also one of school's responsibility,
Nepaali, do you have any idea any schools which are involved in these kind of education?

... please share

Hey,

Like I said earlier, to the best of my knowledge, no schools have safe sex programs as a part of the curriculum. but I do know that B.P Memorial Health Foundation had a fully developed and implemented program on youth reproductive Health and Sexuality. Again, the fact that there aren't more organizations is age old notions of what children do or rather what society thinks they ought to do.

Everyone knows that the youth in Nepal in recent years, have become increasingly active sexually but God forbid we talk about it openly and pressure the education department to start safe sex education because that would be seen as condoning pre-marital sex and worse yet, that the people that teach are actually encouraging the behaviour as oppsed to helping make sure that youth are not infected becuase of their stupidity/ignorance.

The youth themselves really shoulder the burden here--this is the electronic generation so if they can spend hours on the internet, clearly, they have the time and the knowledge to figure out safe sex pages and get the information that keeps them alive and healthy...

I must say that I am horribly dissappointed with a majoirty of the Sajha folks--why the deafening silence?..it's the same names again and again on this thread..which just shows the amount of work that we need to do to get people to start paying attention.