Resistance towards condom use among Nepali migrant workers

A huge number of Nepalese workers migrate to various countries in search of employment opportunities every year. Most of these migrant workers are male that leave their family and children behind as employment opportunities at home are scarce. Migration from Nepal since 1980s has tripled. In certain district of Nepal, up to 40 percent of all economically active males are outside the country in search of decent employment (Hoermann and Kollmair, 2009). Even though there is no concrete figure, it is believed that there are more than one million Nepalese workers working in India alone (Seddon et al., 2001). Attracted by higher income opportunities, affordable transportation costs, and, foremost, visa-free entry, more than 70 percent of Nepals migrant workers go to India in search of work (HMGN, 2001). Many young males of far western region find their way to Indian cities due to their low socioeconomic status, lack of education, and other adverse situations. The far western region of Nepal is the least developed region of the country. Lately, increased prevalence of HIV infection among the migrant males working in various Indian cities has become a growing public health problem. With increased migration, along with increase in remittance flow, the prevalence of HIV infection has also increased, tremendously. Various research (Poudel et al., 2003; Poudel et al., 2004; Poudel et al., 2008) have clearly shown that HIV infection among migrant workers is mainly due to unprotected sex. A study conducted by Poudel et al. (2004) in Far Western Region of Nepal found that around 6- 10% migrant workers returning home from Mumbai, India were infected with HIV. While away from home, migrant workers are out of social controls of family and community. The latest national HIV/AIDS strategy in Nepal has identified mobile populations, particularly labor migrants to India, as one of the most vulnerable groups for HIV infection (National Centre for AIDS and STD Control, 2003). Migration to India has created a high-risk situation for spreading HIV in far western region. These migrant workers acquire HIV infection involving in high risk sexual behavior and transmit virus to their wives during their visit to their home. Migrant workers, thus, are among one of the main culprits behind increase in HIV infection in Nepal. It is important to intervene resistance towards condom use among migrant workers because HIV infection does not always remain contained within the household, as returnees often indulge in extramarital sex after they return to Nepal. Infrequent condom use is rampant among the migrants both at home and abroad (Poudel et. al., 2004), which is causing incidents of HIV infection to rise in the country. It is emerging as a serious public health problem because the adverse affects arising from risky sexual acts not only impact the particular individual in question but also the entire society, both socially and economically.

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