Rajendra Bhattarai

26 August , 2024 / Kathmandu Incident is the initial phase of the first wave of Corona. A doctor working at Bharatpur Hospital in Chitwan was infected with Corona while treating a patient. But the symptoms did not appear, he went to his own house in Ratnanagar municipality and stayed in isolation. After learning that he was infected with Corona, the neighbors came to the house to chase him.

The team that chased him was led by the ward chairman himself. After pleading with the police, he escaped from Lakhet in, but was dragged to the gate of his house with a big banner under the leadership of the ward president. It was written on the banner – ‘This is the house of a corona infected person, no one should go around.’ But within a few months, after about one third of the population was infected with Corona, this situation gradually disappeared.

HIV is not a disease that can be spread from one person to another immediately due to the droplets released by speaking and breathing like the corona virus. It has been 35 years since an HIV-infected person was found in Nepal, but there is a social obligation to hide the disease. Because of this, how many people are infected with HIV in Nepal? There is no such single data. People who are sick and have reached the hospital or live in the risk area are tested voluntarily. Even in such a test, the number of HIV infected people has exceeded 35,000, according to government data. If research is done carefully, the number of HIV infected people in Nepal could be millions.

As serious as the problem of HIV is inside, it is a more serious problem – ‘not wanting to be tested’. The first thing is that everyone has the impression that this is a problem that will never be cured. When it is an incurable disease, why take more stress by getting tested? It seems that mentality. What is even more complicated is the mentality that if others find out that you have HIV, you will live as if you are dead. This is also true. Because it is not possible to go out of the house after revealing the identity of HIV.

Another thing is that HIV is not a disease in itself, it is only a problem of reducing immunity, the government and related agencies have failed to convey to the people the fact that if you are aware of health and take regular medicine if necessary, you do not need to get sick, you will not even die. Many people do not know that HIV testing is done very secretly, and in case of HIV confirmation, free medicine is provided if needed along with proper counseling.

Likewise, the main cause of HIV infection is unprotected sex. Nepalese society considers sex between other than a couple as a heinous crime. This is a situation that the society should not know. If the husband finds out that the wife has had sexual relations with others and the wife finds out that the husband has had sexual relations with others, then the family will immediately break down. That is why there is a problem of not agreeing to get tested for HIV.

Similarly, HIV is another cause of transmission. Many people use the same syringe to use drugs. Even drug users are not able to open up in the society. If the society finds out that he is a drug addict, he will be ostracized. Sex workers are the main carriers of HIV infection. Their situation is even worse than that of drug users. Sex workers are forced to conduct their business in the utmost secrecy.

The first thing is the fear of the society, the second thing is that the government has considered this business illegal. It is not possible to find out the number of male and female sex workers in Nepal. Just guess. If the highway area and urban areas are to be researched roughly, it can be estimated that there are millions of sex workers in Nepal. But due to social and legal complications, it is not easy to inform them about the need for health examination and to make them aware that condoms must be used when having sex.

In recent times, due to access to social networks, unprotected sex is increasing even among non-sex workers. They said hi hello through Facebook, started dating and had sex. The tendency to be afraid or ashamed to go to the drug store to buy condoms because others will find out about having sex like this has also caused problems.

Likewise, millions of young people have gone abroad for employment or other work. Someone’s husband has gone abroad, someone’s wife has gone abroad. The incidents of some people living alone in the country using alternative methods for sexual satisfaction are like ‘open-secret’. Some people are addicted to changing sexual partners. Therefore, it can be assumed that the HIV problem is spreading very rapidly in Nepal.

In fact, the more dangerous the problem of HIV infection in Nepal is, the more dangerous is the level of awareness of the society. According to the estimated data, there are millions of HIV infected people in Nepal. But according to government data, about 30,000 HIV-infected people have been identified, of which more than 10,000 have not received treatment. Even though there has been a lot of progress in the treatment and medication of HIV infected people in Nepal, there is still a large number of infected people who are not being openly treated, the government side says.

Out of the total number of identified infected persons, the number of HIV infected persons under the age of 14 is 4.2 percent. That is, there are 1,268 children. According to Ministry of Health Sexual Disease Treatment Center, 754 people are infected annually. According to the center, 363 infected people died.

Similarly, according to the survey conducted in 2017, it has been found that 2.2 percent of female sex workers and 6.2 percent of male homosexuals are infected with HIV. According to a survey conducted in the West, Central and Far West, HIV infection among working Nepalis in India is 0.3 percent in the West and 0.6 percent in the Middle and Far West.

The government of Nepal has set a goal of ending the AIDS epidemic by 2030. For that, 95 percent results should be achieved in three areas. First, 95 percent of HIV infected people should know about their infection status, secondly, 95 percent should have access to treatment, and third, 95 percent should have a low virus load in their bodies if they take medicine.

HIV and AIDS are two different things. HIV is a virus that causes AIDS. HIV is now seen worldwide as an infection rather than a disease. Not all HIV infected people have AIDS. Today, HIV infected people are getting assurance of easy and long life like others by regular consumption of okhati which is available for free in various government health institutions and adopting a healthy lifestyle.

The rumor that HIV can be spread by laughing, talking, sharing food with an HIV infected person and using the same cloth is just an illusion. If infected blood is donated or received, if a needle used by an infected person is used to pierce the skin, and children born from an infected mother are likely to be infected.

The main way to prevent the spread of HIV is to raise awareness. But the government is not able to take concrete steps for this. Until a few years ago, the government was also working to spread public awareness through the media, but in recent years, the government has failed. Apart from celebrating AIDS Day on December 1 of every year, concrete programs for raising public awareness have not come from the government level.

The government has failed in providing information about sexual health, reproductive rights and reproductive health at the school level, and creating conditions where such matters can be openly discussed. So far, the government has failed to make people aware that HIV and AIDS are two different things.

When talking about HIV, the concept of three zeros is very popular all over the world. The first zero indicates the determination to bring the death rate of HIV infected people to zero, the second zero to bring the rate of new HIV infections to zero, and the third to bring the rate of discrimination against HIV infected people to zero.

To reduce the multi-dimensional impact of HIV, the Government of Nepal has established a National AIDS and Sexually Transmitted Disease Control Center in Teku to work specifically on HIV and sexually transmitted disease issues. Most of the district hospitals and other health centers have made it possible for HIV infected people to take ARV virus medicine for free.

Condoms are available at every health post and medicine shop for a safe sex life. In the recent days, sex, reproductive health, rights and sexually transmitted infections have started to be openly talked about.