Theme: Epidemiology & Public Health Research Year: 2019
Background. Women who use drugs are extremely vulnerable to HIV and sexually transmitted infections
(STIs), but studies on risk behaviors and HIV infection among female drug users are limited in Nepal.
Method: Sathi Samuha conducted this cross-sectional study between September 2016 and May 2017,
HIV prevalence and risk factors for HIV infection were investigated among female drug users recruited in
drop-in centers, parks, and streets in the Kathmandu Valley. The participants completed face-to-face
interviews for a structured questionnaire, HIV pre-test counseling, specimen collection for HIV test and
they were provided with their results at post-test counseling.
Results: A total of 269 female drug users were recruited, of whom 28% were found HIV positive; the
majority 78%, being injecting drug users and aged below 25 years 57%, Nearly half of the total
participants had shared needles or syringes in the past month, and 131 and 102 participants were
involved in commercial or casual sex respectively with only half or less of them having had used
condoms in the last 12 months. In multivariate analysis the variables associated with HIV infection
included: (a) older age; (b) history of school attendance; (c) frequency of sharing of injection
instruments; and (d) unsafe sex with commercial or casual partners.
Conclusions: HIV was highly prevalent among female drug users in the Kathmandu Valley, with its risk
being strongly associated not only with unsafe injection practice but also with unsafe sexual behaviors.
Awareness raising programmes and preventive measures such as condom distribution, needle syringe
exchange, and Female friendly methadone maintenance therapy should be urgently introduced in this
neglected subpopulation.
Disclose of interest: none to declare