Online Program

Understanding HIV-risk behavior among migrants vs. non-migrant workers in Nepal

Tuesday, November 5, 2013 : 10:30 a.m. - 10:45 a.m.

Roman Shrestha, Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT
Tania B. Huedo-Medina, PhD, Statistics & Allied Health Sciences, University of Connecticut, Storrs, CT
Michael Copenhaver, PhD, Department of Allied Health Sciences, University of Connecticut, Storrs, CT
Background: Seasonal migration of Nepali workers to India is common in Nepal. Unsafe sex and alcohol/drug use behaviors of migrant workers, both in India and Nepal, has led to a high HIV-prevalence among this group. This study compared HIV-risk behaviors between migrant and non-migrant workers and examined the role of migration in HIV transmission in Nepal.

Methods: We conducted a cross-sectional study to assess HIV-related knowledge, attitudes and behaviors of migrant (n=20) and non-migrant (n=20) workers in Janakpur, Nepal - a neighboring region to India with high male-migration. We used migration-status stratified regression models to explore association between migration and various HIV-risk behaviors.

Results: Migrants were found to be significantly older than non-migrants (38-years vs. 29-years). Mumbai, Delhi, and Punjab were the most popular cities of destination, where HIV-prevalence among sex-workers is high. Compared to non-migrants, migrants were more likely to engage in sex with sex-workers (90% vs. 60%), have multiple sex-partners (85% vs. 60%), inconsistent condom use (“always-used-condom”: 0% vs. 35%), and drink alcohol before sex (55% vs. 35%). Among migrants who never used condom, “didn't think it was necessary” was the key reason for non-use. Migrants had substantial deficits in HIV/AIDS knowledge, and safe-sex skills vs. non-migrants. Post-migration social isolation was found to play a significant role in increasing HIV-risk behaviors.

Conclusions: Migrant workers tend to have greater HIV-risk behaviors vs. non-migrant workers. Thus, there is a need for comprehensive HIV/AIDS programs tailored to address migrant workers in order to reduce the risk of spreading HIV.

Learning Areas:

Diversity and culture
Protection of the public in relation to communicable diseases including prevention or control
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify various HIV-risk behaviors associated with seasonal Nepali migrant workers to India. Describe the role that seasonal migration plays in transmission of HIV among returnee male migrant workers in Nepal.

Keyword(s): HIV Risk Behavior, Migrant Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in HIV prevention research on multiple projects both nationally and internationally. My current work includes behavioral HIV prevention intervention engaging various vulnerable populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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