Here's
the abstract of Praveen Paudel's dissertation submitted to University of
Northampton, titled "Issues and barriers of HIV/AIDS interventional programmes: A systematic review of current HIV epidemiology of Nepal".
The overall prevalence of Human Immune Deficiency Virus
(HIV) infection among most at risk population (MARP) group in Nepal is
declining, however, the HIV prevalence among the low risk group (general
population) is thought to be increasing via bridging population. Sexual
networking and drug use might be working as the bridge for the transmission of
HIV among these two groups. Barriers in the interventional programmes are the
cause behind shift in HIV transmission.
Objective of this study was to systematically review the situation of HIV
epidemiology in Nepal with a view to identifying the proportion of people
affected by HIV infection among various risk groups and explores the barriers
for the effectiveness of Internationale programs. This study used systematic review of journals and
reports covering electronic database, web-based information, contacting to
authors from reference list and personal contact with experts.
A large gap exists between reported and estimated HIV infection
cases in Nepal. The actual number of HIV prevalence in Nepal might be much
higher than estimated cases because most of the estimation at present is
town/city centred- missing remaining areas (districts) which are not covered by
the projects. Likewise the interventional programmes have covered only sub-set of
their targeted population; the risk behaviours of the remaining population uncovered
by the programmes are found to fuel the transmission of this disease to the
general public. The major barriers for
the ineffectiveness of interventional programmes are the pertinent cultural
issues which the interventional programmes have not been able to address. Also
issues at programme management level and service seeking level are potential
barriers contributing for HIV epidemic in Nepal.
Despite the progress that has been made so far to
reduce HIV transmission in Nepal, a proper scientific mechanism of case
identification for all risk population groups throughout country is still
missing. Research on sexual networking and HIV transmission from high risk to
low risk (general population) is urgently required to control HIV transmission
in Nepal.
(One can contact researcher at pp_praveen@hotmail.com if s/he wants to know more about his ground breaking research)
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