Himalayan seasonal migration and STI/HIV infection: a case study among seasonal migrants in Kathmandu from Dolpa district, Nepal.

Thesis Report.

SUMMARY: The objective of the study was to explore the relationship between seasonal migration and STI/HIV among seasonal migrants of upper Dolpa who migrated to Kathmandu during the winter season from November 2005 to February 2006. Research methodologies employed in the study included descriptive research design with various research tools such as scheduled questionnaire, laboratory test, and focus group discussion. A total of 65 participant both males and females aged 15 to 59 years, were selected by incidental sampling method. The study revealed that there were various causes for seasonal migration in winter: extreme cold, desire to go on a pilgrimage, visit their relatives, and search for employments and entertainment. The highest number of migrants was in the age group of 15 to 24 years (61.5%) followed by 25 to 34 years (16.9%). The majority of the respondents who came to Kathmandu belonged to middle class (44.6%), about one-third (29.2%) lower class and one-fourth (26.2%) rich class. The majority of the respondents (81.5%) stayed in upper Dolpa only for 6 to 9 months. The majority (73.2%) of the respondents' age at first marriage was 20 to 24, although premarital sexual activities started earlier, more than half (62.5%) of the respondents started their sexual activities at the adolescent age (9-19 years). An overwhelming number of male respondents (82%) had experienced sex at the age of 9 to 19 years. About 97 percent males used alcohol either daily or at least once a week and 50 percent, female respondents used alcohol in the same manner. Less than half of the respondents (44.6%) had heard about condom; an overwhelming number of respondents (92.3%) had never used condom. Only 1.5 percent respondents occasionally used condom for protection against ST/HIV. The majority of the, respondents (78.4%) had not heard about HIV/AIDS. Of those who had heard, about three-fourths (78.6%) were not aware of the place of HIV testing. About one-fourth (21.5%) of the respondents had heard of gonorrhea and HIV/AIDS, but no one had heard of syphilis. The study revealed that the male respondents were more infected with Hepatitis B virus (38.7%) than females (35.3%). The highest percentage (58.5%) of HBsAg reactive respondents were found in the age group of 35 to 39 years and more frequent migrants, but positive-negative ratio was higher in the age group of 25 to 29 years (1.5) and 20 to 24 years (1.33). Given the characteristics of seasonal migrants like use of alcohol, earlier sexual activities, late marriage, unsafe sexual relationship, unawareness about STI/HIV/AIDS, lack of knowledge about condom. Wide practice of unsterilized surgical procedures even as they are on the way to their destination. The migrants are at great risk of getting infected with STI/HIV/AIDS during migration. A clear-cut policy should be formulated regarding Himalayan seasonal migration and its impact on STI/HIV/AIDS. Hapatitis B vaccination and extensive awareness program with voluntary counseling and testing services on SIT/HIV/AIDS should be launched immediately in upper Dolpa.