Review of current HIV epidemiology of Nepal

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)