Injecting drug use and HIV vulnerability in Nepal
Document type: mthesis
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Abstract:
The thesis addresses injecting drug users and their vulnerability to HIV in Nepal. Injecting drug use (IDU) remains the major factor contributes to the increase of the HIV epidemic throughout the country. Injecting drug users (IDUs) function as a ‘core group’ that bridge HIV transmission between at-most risk groups and general population. The main objective of this thesis is to find out the most important determinants that fuel HIV infection among IDUs in order to provide recommendations to enable various effective interventions in reducing injecting drug use and HIV vulnerability in Nepal. Literature reviews of published and unpublished literature, conference reports and key informants e-mail communications were done. The conceptual framework used for the analysis of HIV in relation to IDUs in Nepal is the “key determinants of vulnerability to HIV infection among injecting drug users” accessed from World Health Organization (2005). The study identified the main factors responsible for the spread of HIV among IDUs in Nepal such as: Micro-environmental constraints (negative perception of society to IDUs, living within IDUs networks and participating sharing injection behaviors in IDUs groups); Macro-environmental factors (unclear national policy guidelines in reducing HIV among IDUs, lack of law enforcement and limit resources to management of risk behaviors, economic barrier; Structural determinants (lack of political will, limited drug policy and weak legal framework to handle drug related matter, stigma and discrimination, police harassment and incarceration of IDUs, low accessibility of VCT, drug treatment and care services); Individual and peer group determinants: lack of knowledge on prevention and modes of HIV transmission escalates risk behaviors, injecting behaviors (shared injecting equipment, improper needle and syringe cleaning practices, use of contaminated injecting equipment), sexual behaviors (inconsistent condom use, buying and selling sex, having unprotected sex with multi-sex partners including sex workers). Reviewed literatures, international interventions and country itself experiences highlights the various factors that contribute to increase or decrease HIV infection among IDUs. Several countries have shown good examples in preventing and controlling of HIV infection to IDUs and best practices on harm reduction program, from which lessons can be drawn to inform the evidence of relevance and for better future effectiveness of interventions efforts in Nepal.
Authors:
Ramtel, T.
Country:
Nepal
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
HIV and AIDS
,
disease prevention and control
,
health services
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
viii, 62
Year:
2008
Region:
South Asia
Right:
© 2008 Ramtel
Subject:
Health and Nutrition
Title:
Injecting drug use and HIV vulnerability in Nepal
Training:
Master of Public Health / International Course in Health Development (ICHD)