Namrata husband didn't use condoms even though, as she later found out, he had known he was infected for several years. When she told him she had tested HIV-positive, he left her.
"Women still do not have equal economic or educational or occupational or social options - men have greater power than women, and the imbalance in power negatively affects women's abilities to prevent being infected. Long-term strategies will depend on improving women's economic and social status. Empowering women is no longer an option, it is essential."
"HIV/AIDS is not a health problem, it is a socioeconomic and development problem."
"Women are silent about sexual issues for many reasons. Lack of respect for women's sexual and reproductive rights is a big problem in Nepal. Female genital mutilation, early and compulsory marriage of girl children, sexual exploitation, abuse and rape of girls and women, and the lack of any opportunity for may women to refuse unprotected sex all contribute to the high risk of HIV infection among Nepalese women. And all represent clear violations of women's sexual rights".
"Nepalese women cannot request, let alone insist on using a condom or any form of protection. Poor hygiene and limited health care foment sexually transmitted diseases, which strike women more than men and make HIV transmission more likely. Women must be empowered so that they are able to control their sexual relations".
We Nepalese have three main challenges-The first is the promotion of safer sexual behavior. Our challenges here are not only to help people adopt safer sex, but also to design programs of communication and education with the view to mobilize women and people outside Kathmandu valley. In giving emphasis to AIDS publicity, AIDS education could play very effective role in controlling the disease. Increasing awareness is just imperative among women and girls who are the risk groups in several ways. Spreading message about the use of condoms to counter the AIDS threat is equally important. This again indicates that socio-economically imbalanced girls/women of Nepal are going to face the additional burden of AIDS crisis. Women in Nepal are facing bigger risk from AIDS virus and HIV transmissions is narrowing.
Women living with HIV in Nepal have no access to family planning services. They also suffer violence in the denial of their sexual and reproductive and economic rights. They are generally expected to interrupt their sex lives and forego childbearing to avoid transmitting the virus. In Nepal, we need to emphasize a family and approach to reproductive health and to develop a more helpful continuum of care.
Indeed, the government and NGOs could make remarkable contribution to check the spread of AIDS but most NGOs working on AIDS are not strong in Nepal. There is much duplication of activities including the development of health education materials. There is no focal point for the development of a policy for the district level AIDS programs. Lack of good counseling and follow up services, the victims of AIDS diseases are increasing.
The majority of HIV infected cases belong to the 20-29 age groups. Overall, the data suggests that HIV infection is becoming widespread and the rates of HIV-infected mothers are between 25 and 40 percent. According to WHO, the young children and virgins fall in a high risk group for contracting HIV through having sex with HIV carrier. According to American epidemiologist has estimated the number of HIV positive cases in Nepal by the end of last year may have reached nearly 25,000. The number of cases of full blown AIDS at the start of the new millennium is estimated to be 8,763 people.
The National AIDS Control Program was established in 1987 under the Department of Health. In 1995, a National Policy on HIV/AIDS/STDs was adopted by the Ministry of Health, and a multisectoral approach involving 12 government ministries was established. Even government has established a National AIDS Council chaired by the Prime Minister. The National Center for AIDS and STD Control under Ministry of Health is in the process of updating the National Strategy on HIV/AIDS for the Tenth Five Year Plan period. Yet, government departments are forced to combat the epidemic with limited funds available and the Health Ministry itself does not have enough professional or material resources to fight the spread of HIV.
HIV/AIDS prevention and control requires a multisectoral approach. A special focus is needed to alleviate the issue of trafficking of women. Lack of commitment and policy implementation pose as obstacles in solving the crisis. With the restoration of a multiparty democracy the people expect social security, justice, peace, health care, in society but Nepal's rules and regulations are incomplete as far as protection of innocent girls' trafficking is concerned. People, who traffic girls and women, capitalize on the economic situation of the destitute and unfortunate putting them at high risk for STDs and AIDS.
In order to achieve the goal in reducing AIDS threat, literacy rate especially for women has to be improved. AIDS counseling and follow-up should be strengthened and sexual biasness for boys over girls should be eliminated from society.
Working in partnership with international organizations, government NGOs must focus on reaching the goal of AIDS prevention through information, education, condom distribution. They should plan organize an implement programs effectively. May this way we can protect our invaluable citizens from HIV and AIDS threat.
(Kamala Sarup recently wrote a Book on "Women trafficking, HIV and role of media" supported by B.P. Koirala Foundation).
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