HIV/AIDS in Nepal

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Chart showing the estimated number of HIV infections among key population groups aged 15-49 years from 1980 to 2014 Chart showing the estimated number of HIV infections amoung Key population Groups aged 15-49 years from 1980 to 2014.png
Chart showing the estimated number of HIV infections among key population groups aged 15-49 years from 1980 to 2014

The first HIV/AIDS cases in Nepal were reported in 1988. The HIV epidemic is largely attributed to sexual transmissions and account for more than 85% of the total new HIV infections. Coinciding with the outbreak of civil unrest, there was a drastic increaase in the new cases in 1996. The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), male sex workers (MSWs), injecting drug users (IDUs), men who have sex with men (MSM), Transgender Groups (TG), migrants and Male Labor Migrants (MLMs) as well as their spouses. Socio-Cultural taboos and stigmas that pose an issue for open discussion concerning sex education and sex habits to practice has manifest crucial role in spread of HIV/AIDS in Nepal. With this, factors such as poverty, illiteracy, political instability combined with gender inequality make the tasks challenging. [1] [2]

As of December 2007, the Government of Nepal reported 1,610 cases of AIDS and 10,546 HIV infections, which has grown to 13,000 infections by World AIDS Day 2008. [3] UNAIDS estimates from 2007 indicate that approximately 75,000 people in Nepal are HIV-positive, including all age groups. The Government of Nepal's National Center for AIDS & STD Control (NCASC) estimated that number to be closer to 70,000 in December 2007. In a study from 2014, an overall national HIV prevalence was 0.20% (adult male 0.28%, adult female 0.13%). According to UNAIDS, by the end of 2015, the number of people living with HIV was 39,000 [34,000 - 46,000] [4] NCASC (2010) reports that estimated number of HIV infections by risk groups is 59,984 [5] [2] In terms of absolute numbers, Nepal's 1.5 million to 2 million labor migrants account for the majority of Nepal’s HIV-positive population. In one subgroup, 2.8 percent of migrants returning from Mumbai, India, were infected with HIV, according to the 2006 IBBS among migrants. [4]

As of 2007, HIV prevalence among female sex workers and their clients was less than 2 percent and 1 percent, respectively, and 3.3 percent among urban-based MSM. The NCASC reports HIV infections to be more common among men than women, as well as in urban areas and the far western region of Nepal, where migrant labor is more obvious. According to Nepal's 2007 United Nations General Assembly Special Session (UNGASS) report, labor migrants make up 41 percent of the total known HIV infections in Nepal, followed by clients of sex workers (15.5 percent) and IDUs (10.2 percent). [4] The annual new infection in 2014 is estimated at 1,493 and is expected to decline by 899 by 2020. An estimated number of 2,576 deaths were caused by AIDS in 2014, lower compared to estimated 3,362 deaths in 2013 which is, largely due to increased access to treatments. Poverty, low levels of education, illiteracy, gender inequalities, marginalization of at-risk groups, and stigma and discrimination compound the epidemic's effects. Unsafe sex and drug injection practices, civil conflict, internal and external mobility, and limited adequate health care delivery multiply the difficulties of addressing HIV/AIDS. Moreover, existing care and support services are already overwhelmed as increasing numbers of HIV-infected individuals become sick with AIDS. [4] [2] The UNICEF report, "Increasing Vulnerability of Children in Nepal", estimates the number of children orphaned by HIV/AIDS to be more than 13,000. The national estimate of children 0 to 14 years of age infected by HIV is 2,500 (2007). [4] Nepal has a high tuberculosis (TB) burden, with 81 new cases per 100,000 people in 2005, according to the World Health Organization. HIV infects 3.1 percent of adult TB patients, and HIV-TB co-infections complicate treatment and care for both diseases. [4]

Table showing estimated HIV infections in Key affected populations in Nepal in 2011.png

Due to cultural, social and economic constraints, it becomes difficult for FSWs to negotiate condom usage with their clients or obtaining health services and legal counseling. Their clients consist of transport workers, members of police force or military, and migrant workers who do not use condoms which constitutes 60% of their client base. Trafficking of Nepalese girls and women into commercial sex work in India has been a major issue to HIV.50% of Nepalese sex workers in Mumbai brothels are HIV positive (FHI 2004). Given the nature of the epidemic in Nepal, most of the national initiatives have focused on leadership, partnerships and the involvement of civil society for prevention, care, and support for its most-at-risk populations. From 2003, the NCASC implemented the HIV/AIDS Operational Plan based on the National Strategy 2002–2006.[ citation needed ] Currently, the HIV/AIDS activities are shaped by the second National HIV/AIDS Strategy 2007–2011, and implementation is coordinated under the 2006–2008 National Action Plan, which has the following priorities:

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Epidemiology of HIV/AIDS Pandemic of Human Immunodeficiency Virus

The global pandemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), as of 2021, HIV/AIDS has killed approximately 40.1 million people, and approximately 38.4 million people are infected with HIV globally. Of these 37.7 million people, 73% have access to antiretroviral treatment, and 16% do not know they were infected. There were about 770,000 deaths from HIV/AIDS in 2018, and 680,000 deaths in 2020. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in eastern and southern Africa. As of 2020, there are approximately 1.5 million new infections of HIV per year globally.

HIV/AIDS in Asia

In 2008, 4.7 million people in Asia were living with human immunodeficiency virus (HIV). Asia's epidemic peaked in the mid-1990s, and annual HIV incidence has declined since then by more than half. Regionally, the epidemic has remained somewhat stable since 2000.

HIV is recognized as a health concern in Pakistan with the number of cases growing. Moderately high drug use and lack of acceptance that non-marital sex is common in the society have allowed the HIV epidemic to take hold in Pakistan, mainly among injecting drug users (IDU), male, female and transvestite sex workers as well as the repatriated migrant workers. HIV infection can lead to AIDS that may become a major health issue.

According to experts, the total number of individuals with HIV was estimated in 2016 to be between 0.85 and 1.5 million. As for 2016, the prevalence of HIV in adult people was between 0.8 and 1%, and according to the UN, Russia had one of the fastest growing HIV/AIDS epidemics in the world. Approximately 95,000 Russians were diagnosed with HIV in 2015, and approximately 75,000 in the first nine months of 2016. Stigma surrounding the disease, and government indifference have contributed to the crisis. As of 2016 the HIV/AIDS epidemic, despite successes with intravenous drug users, was poised to move into the general population of sexually active young people.

Since the first HIV/AIDS case in the Lao People's Democratic Republic (PDR) was identified in 1990, the number of infections has continued to grow. In 2005, UNAIDS estimated that 3,700 people in Lao PDR were living with HIV.

HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).

With less than 0.1 percent of the population estimated to be HIV-positive, Bangladesh is a low HIV-prevalence country.

UNAIDS has said that HIV/AIDS in Indonesia is one of Asia's fastest growing epidemics. In 2010, it is expected that 5 million Indonesians will have HIV/AIDS. In 2007, Indonesia was ranked 99th in the world by prevalence rate, but because of low understanding of the symptoms of the disease and high social stigma attached to it, only 5-10% of HIV/AIDS sufferers actually get diagnosed and treated. According to the a census conducted in 2019, it is counted that 640,443 people in the country are living with HIV. The adult prevalence for HIV/ AIDS in the country is 0.4%. Indonesia is the country is Southeast Asia to have the most number of recorded people living with HIV while Thailand has the highest adult prevalence.

Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.

HIV/AIDS in Bolivia has a less than 1 percent prevalence of Bolivia's adult population estimated to be HIV-positive and therefore the country has one of the lowest HIV prevalence rates in the Latin America and Caribbean region.

Cases of HIV/AIDS in Peru are considered to have reached the level of a concentrated epidemic. According to a population-based survey conducted in Peru’s 24 largest cities in 2002, adult HIV prevalence was estimated to be less than 1 percent. The survey demonstrated that cases are unevenly distributed in the country, affecting mostly young people between the ages of 25 and 34. As of July 2010, the cumulative reported number of persons infected with HIV was 41,638, and there were 26,566 cases of AIDS, according to the Ministry of Health (MOH), and the male/female ratio for AIDS diagnoses in 2009 was 3.02 to 1. The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates 76,000 Peruvians are HIV-positive, meaning that many people at risk do not know their status. There were 3,300 deaths due to AIDS in Peru in 2007, down from 5,600 deaths in 2005.

The Dominican Republic has a 0.7 percent prevalence rate of HIV/AIDS, among the lowest percentage-wise in the Caribbean region. However, it has the second most cases in the Caribbean region in total, with an estimated 46,000 HIV/AIDS-positive Dominicans as of 2013.

HIV/AIDS in Jamaica has a 1.5 percent prevalence of the adult population estimated to be HIV-positive and no significant change over the last five years and therefore Jamaica appears to have stabilized its HIV/AIDS epidemic.

In 2016, the prevalence rate of HIV/AIDS in adults aged 15–49 was 0.3%, relatively low for a developing country. This low prevalence has been maintained, as in 2006, the HIV prevalence in Mexico was estimated at around 0.3% as well. The infected population is remains mainly concentrated among high risk populations, men who have sex with other men, intravenous drug users, and commercial sex workers. This low national prevalence is not reflected in the high-risk populations. The prison population in Mexico, faces a fairly similar low rate of around 0.7%. Among the population of prisoners, around 2% are known to be infected with HIV. Sex workers, male and female, face an HIV prevalence of around 7%. Identifying gay men and men who have sex with other men have a prevalence of 17.4%. The highest risk-factor group is identifying transgender people; about 17.4% of this population is known to be infected with HIV. Around 90% of new infections occur by sex-related methods of transmission.. Of these known infected populations, around 60% of living infected people are known to be on anti-retroviral therapy (ART).

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year. But, in 2012 and 2013 it increased to about 600 new cases and in 2014 it reached 880 new cases per year. According to UNAIDS 2016 statistics, there are about 11,000 people currently living with HIV in Egypt. The Ministry of Health and Population reported in 2020 over 13000 Egyptians are living with HIV/AIDS. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

With 1.28 percent of the adult population estimated by UNAIDS to be HIV-positive in 2006, Papua New Guinea has one of the most serious HIV/AIDS epidemics in the Asia-Pacific subregion. Although this new prevalence rate is significantly lower than the 2005 UNAIDS estimate of 1.8 percent, it is considered to reflect improvements in surveillance rather than a shrinking epidemic. Papua New Guinea accounts for 70 percent of the subregion's HIV cases and is the fourth country to be classified as having a generalized HIV epidemic.

Vietnam faces a concentrated HIV epidemic.

Morocco has been identified as one of the best countries within the MENA region in dealing with the HIV epidemic based on their research capacities, surveillance systems, and evidence-informed and comprehensive responses. While the general public has a fairly low HIV prevalence, the majority of HIV/AIDS cases can be found in 3 high risk groups, which is important when deciding how to approach intervention and prevention.

References

  1. ↑ Beine, David. 2003. Ensnared by AIDS: Cultural Contexts of HIV/AIDS in Nepal. Kathmandu, Nepal: Mandala Book Point.
  2. 1 2 3 "Country Progress Report Nepal".UNAID.
  3. ↑ Nearly 13,000, The Hindu, "Nearly 13,000 HIV/AIDS cases recorded in Nepal", December 8, 2008, retrieved April 28, 2011.
  4. 1 2 3 4 5 6 7 "Health Profile: Nepal" Archived 2008-08-17 at the Wayback Machine . United States Agency for International Development (March 2008). Accessed August 25, 2008. PD-icon.svgThis article incorporates text from this source, which is in the public domain .
  5. ↑ "Home". ncasc.gov.np.
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