District AIDS Coordination Committee (DACC), District Health Office, Silgadhi, Doti, Nepal.
PLoS One. 2013 Sep 5;8(9):e74903. doi: 10.1371/journal.pone.0074903. eCollection 2013.
Around 41% of Human Immunodeficiency Virus (HIV) cases in Nepal occur in seasonal migrant laborers. Dalit migrant laborers represent the largest proportion of reported HIV cases in the Far Western Region (Sudur Pashchimanchal, or Far West), Nepal. The study's objectives were to assess sexual behavior, condom use status and HIV risk perception among Dalit migrant laborers to India from Far West Region, Nepal.
The study was conducted among Dalit male migrant laborers aged 15 years and above who had migrated for at least six months of the last two years to India. For the sampling the village development committees (VDCs) from Achham, Doti and Kanchanpur districts of Nepal were purposively selected. The data were collected in March and April 2011 via ten in-depth interviews and four focus group discussions and analyzed using content analysis.
Poor socio-economic status, caste-related discrimination, and lack of employment opportunities push large groups of young Dalits to migrate to India for employment, where they engage in sex with female sex workers (FSWs). The participants described unmarried status, peer influence, alcohol use, low-priced sex with FSWs and unwillingness to use condoms as common factors of their migration experience. Lack of awareness on HIV/AIDS was common among study participants. Awareness of HIV/AIDS and faithful, monogamous partnerships are reported as factors influencing safer sexual behavior.
Dalits are an especially vulnerable population among migrant laborers and may be over-represented in new HIV infections in Nepal. Comprehensive surveying and health promotion programs targeted to this population are urgently needed and potent methods of stopping HIV spread.
在尼泊尔，约有 41%的人类免疫缺陷病毒（HIV）病例发生在季节性移民工人中。在尼泊尔远西部（苏都帕斯查姆查尔，或远西），达利特移民工人占报告 HIV 病例的最大比例。本研究的目的是评估来自尼泊尔远西部到印度的达利特移民工人的性行为、 condom 使用状况和 HIV 风险认知。
该研究是在过去两年中至少有六个月前往印度的 15 岁及以上的达利特男性移民工人中进行的。为了进行抽样，尼泊尔阿恰姆、多蒂和坎昌布尔地区的村发展委员会（VDC）被有目的地选择。数据于 2011 年 3 月至 4 月通过 10 次深入访谈和 4 次焦点小组讨论收集，并使用内容分析法进行分析。
贫穷的社会经济地位、种姓相关的歧视以及缺乏就业机会促使大批年轻的达利特人移民到印度就业，在那里他们与性工作者（FSW）发生性行为。参与者描述了未婚状态、同龄人的影响、饮酒、与 FSW 发生低价性行为以及不愿意使用 condom 是他们移民经历的常见因素。研究参与者普遍缺乏对 HIV/AIDS 的认识。对 HIV/AIDS 的认识和忠诚、一夫一妻制的伴侣关系被报告为影响更安全性行为的因素。
达利特人是移民工人中一个特别脆弱的群体，可能在尼泊尔新的 HIV 感染中人数过多。迫切需要针对这一人群的全面调查和健康促进计划，以及有效的阻止 HIV 传播的方法。
