Nepal

2 Basic socio-demographic indicators HIV prevalence and epidemiological status (1990-2011) Risk behaviors (2002-2011) Vulnerability and HIV knowledge (2005-2011) HIV Expenditure (2007) National Response (2005-2011) Archives CONTENT

3 BASIC SOCIO-DEMOGRAPHIC INDICATORS Source: 1.UNFPA. (2010). State of World Population 2010 2. UN Statistics Division. (2010). Social Indicators 3.Word Bank. World Data Bank: World Development Indicators & Global Development Finance. Retrieved January, 2011, from http://databank.worldbank.org/ddp/home.do?Step=12&id=4&CNO=2, 4. WHO. (2010). World Health Statistics 2010, 5. UNDP. (2010). Human Development Report 2010, and 6. UN Population Division. (2009). World Population Prospects The 2008 Revision.

Risk behaviours

% of sex workers who reported condom use with their most recent client, 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Female Sex Workers (Fact Sheet), Kathmandu and Pokhara Valleys, round IV, 2011

6 % of female sex workers who reported consistent condom use in the last 12 months by type of partner, Kathmandu, 2004 - 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Female Sex Workers (Fact Sheet), Kathmandu and Pokhara Valleys, round IV, 2011

7 % of female sex workers who reported consistent condom use in the last 12 months by type of partner, Pokhara Valley, 2004 - 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Female Sex Workers (Fact Sheet), Kathmandu and Pokhara Valleys, round IV, 2011

8 % of female sex workers who were forced to have sex and who were physically assaulted in the last 12 months, 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Female Sex Workers (Fact Sheet), Kathmandu and Pokhara Valleys, round IV, 2011

9 % of female sex workers in the survey who were younger than 20 years of age, 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Female Sex Workers (Fact Sheet), Kathmandu and Pokhara Valleys, round IV, 2011

10 Average duration of sex work among female sex workers, 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Female Sex Workers (Fact Sheet), Kathmandu and Pokhara Valleys, round IV, 2011

11 % of key affected populations who used condom at last sexual encounter, 2008-2009 Source:Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal. (2010). UNGASS Country Progress Report 2010: Nepal

12 % of PWID and MSM who used condom at last sexual encounter by age group, 2009 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal. (2010). UNGASS Country Progress Report 2010: Nepal

13 % of PWID who reported consistent condom use with female sex workers in the last 12 months, selected region, 2002 - 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Injecting Drug Users (Fact Sheet), Kathmandu and Pokhara Valleys, round V, 2011

14 % of PWID who reported unprotected sex in the last 12 months by type of partner, Kathmandu and Pokhara Valley, 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Injecting Drug Users (Fact Sheet), Kathmandu and Pokhara Valleys, round V, 2011

15 % of PWID with consistent condom use in the last year with different types of sexual partners, Kathmandu valley, 2002-2009 Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioral Survey among IDUs_Kathmandu Valley, Round I to Round IV, 2002-2009

16 % of PWID with consistent condom use in the last year with different types of sexual partners, Pokhara valley, 2003-2009 Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioral Survey among IDUs_Pokhara Valley, Round I to Round IV, 2003-2009

17 % of PWID with consistent condom use in the last year with different types of sexual partners, Eastern Terai, 2003-2009 Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioral Survey among IDUs_EasternTerai, Round I to Round IV, 2003-2009

18 % of PWID with consistent condom use in the last year with different types of sexual partners, Western to Far-Western Terai, 2005-2009 Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioral Survey among IDUs, Western to Far-Western Terai, Round I to Round III, 2005-2009

19 % of PWID reporting the use of a condom the last time they had sexual intercourse, 2006-2007 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, & UNAIDS. (2008). UNGASS Country Progress Report: Nepal.

20 % of PWID who reported sharing injecting equipment and needles in the last week, 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Injecting Drug Users (Fact Sheet), Kathmandu and Pokhara Valleys, round V, 2011

21 % of PWID reporting the use of sterile injecting equipment in the last time they injected, 2009 Source: Prepared by www.aidsdatahub.org based on USAID, ASHA Project, & National Center for AIDS and STD Control. (2009). IBBS 2009, Round IV, Injecting Drug Users (IDUs), Kathmandu, Pokhara, Eastern Terai, Western to Far Western Terai

22 % of PWID reporting the use of sterile injecting equipment in the last time they injected, 2006-2009 Source: Prepared by www.aidsdatahub.org based on 1. National Centre for AIDS and STD Control Nepal, & UNAIDS. (2008). UNGASS Country Progress Report: Nepal. 2. National Centre for AIDS and STD Control Nepal. (2010). UNGASS Country Progress Report 2010: Nepal

23 % of PWID in the survey who were younger than 25 years of age, 2011 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, New ERA & Intrepid Nepal (2011), Integrated Biological and Behavioral Surveillance among Injecting Drug Users (Fact Sheet), Kathmandu and Pokhara Valleys, round V, 2011

24 % of MSM with consistent condom use in the last year with different types of sexual partners, Kathmandu valley, 2004-2009 Source:Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioral Survey among MSM and Male Sex Workers_ Kathmandu Valley, Round I to III, 2004-2009

25 % of men reporting the use of a condom the last time they had anal sex with a male partner, 2006-2007 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal, & UNAIDS. (2008). UNGASS Country Progress Report: Nepal

26 % of sex workers reporting the use of a condom with their most recent client, 2007-2009 Source: Prepared by www.aidsdatahub.org based on National Centre for AIDS and STD Control Nepal. (2010). UNGASS Country Progress Report 2010: Nepal

27 % of condom use at last sex and consistent condom use in the last year among sex workers with different types of sexual partners, 22 Highway Districts, 2009 Source: Prepared by www.aidsdatahub.org based on FHI, ACNielsen Nepal Pvt Ltd, STD/AIDS Counseling and Training Services, et al. (2009). Integrated Biological and Behavioral Surveillance Survey among Female Sex Workers in 22 Terai Highway Districts of Nepal.

28 % of condom use at last sex and consistent condom use in the last year among sex workers with different types of sexual partners, Kathmandu and Pokhara valley, 2008 Source: Prepared by www.aidsdatahub.org based on 1. USAID, Advancing Surveillance Policies Prevention Care and Support to Fight HIV/AIDS, & National Centre for AIDS and STD Control Nepal. (2008). Integrated Biological and Behavioral Surveillance Survey among Female Sex Workers Kathmandu Valley: Round III -2008, and 2. USAID, Advancing Surveillance Policies Prevention Care and Support to Fight HIV/AIDS, & National Centre for AIDS and STD Control Nepal. (2008). IBBS among Female Sex Workers Pokhara Valley Round III -2008.

29 % of male migrant laborers who used condom at last sex with female sex workers, 2006-2008 Source: Prepared by www.aidsdatahub.org based on 1.FHI and USAID. (2006). Integrated Bio-Behavioral Survey among Male Labor Migrants in 11 Districts in Western, Mid and Far Western Regions of Nepal 2006, and 2. USAID, Advancing Surveillance Policies Prevention Care and Support to Fight HIV/AIDS, & National Centre for AIDS and STD Control Nepal. (2008). IBBS among Male Labor Migrants in 11 Districts in Western and Mid to Far-Western Regions of Nepal. Integrated Biological and Behavioral Survey among Male Labour Migrants_11 Districts of Western and Mid to Far Western Region, 2006-2008

30 % of men (15-49 yr) with mean number of life-time sexual partners, by marital & residential status, 2006 1.7 1.9 1.9 2.1 2.2 2.5 2.6 3.4 0 1 2 3 4 Terai Married Rural Urban Hill Mountain Never married Divorced/widowed Mean number of partners Source: Prepared by www.aidsdatahub.org based on Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc.

31 % of men (15-49 yr) who had higher-risk sex during the past 12 months, by marital & residential status, 2006 Source: Prepared by www.aidsdatahub.org based on Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc. Marital status Place of residence Higher-risk sex: sex with non-regular, non-cohabitating partner 2. National average for men 15-49 yrs = 5.5 % (N=4,016) 3. Nearly 100% of the never married men (N=1,207) reported having higher-risk in the past 12 months 96.5 1.8 10.7 4.5 5.4 6.6 4.7 0 20 40 60 80 100 Never married Married Urban Rural Mountain Hill Terai (%)

32 % of men (15-49 yr) reporting condom use during high-risk sex in past 12 months, by marital & residential status, 2006 Source: Prepared by www.aidsdatahub.org based on Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc. 1. Higher-risk sex: sex with non-regular, non-cohabitating partner 2. National average for men 15-49 yrs = 71.2 % Marital status Place of residence

33 % of men (15-49 yr) who had multiple partners in the past 12 months, by age, 2006 1. National average for men 15-49 yrs = 3 % Source: Prepared by www.aidsdatahub.org based on Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc.

% young people (15-24 yr) who had sex before the age of 15, by education, 2006 Source: Prepared by www.aidsdatahub.org based on Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc. 13 9.4 4.5 0.3 7.5 9.7 4.8 4.5 0.2 4 0 3 6 9 12 15 No education Primary completed Some secondary Secondary+ National Education level completed (%) Female Male 34

35 % of young men (15-24 yr) who had higher-risk sex during the past 12 months, by wealth quintile & region, 2006 Source: Prepared by www.aidsdatahub.org based on Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc. 1. Higher-risk sex: sex with non-regular, non-cohabitating partner 2. National average = 19.6 % 13.9 11.6 12.3 22.6 36.3 21.9 20.2 21.3 20.2 12.2 0 9 18 27 36 45 Lowest Second Middle Fourth Highest Eastern Central Western Mid- Western Far- Western (%) Wealth quintile Region

Risk behaviours

37 Median number of clients of FSWs per day, 1999-2002 Source: Prepared by www.aidsdatahub.org based on Behavioral Surveillance Surveys in Highway routes of Nepal , round I, II, III and IV, 1999-2002 1.8 1.7 1.6 1.7 1.5 1.55 1.6 1.65 1.7 1.75 1.8 1.85 Round 1 (1999) Round 2 (2000) Round 3 (2001) Round 4 (2002) Median number of clients per day

38 % of men in high-risk occupation reporting ever visiting FSWs, 1998-2001 Source: Prepared by www.aidsdatahub.org based on Behavioral Surveillance Surveys in Highway routes of Nepal , round I, II, III and IV, 1999-2002 74.3 68.5 64 81 34.7 33.5 28 55.7 0 25 50 75 100 1998 1999 2000 2001 Year (%) Transport worker Male labor

39 % of males in high-risk groups used condom during sex with FSWs in the past 12 months, 2001 Source: Prepared by www.aidsdatahub.orgbased on FHI and USAID. (2002). Behavioral Surveillance Survey in the Highway Route of Nepal: Round No. 4 60.4 0 24.9 8.3 3.9 1.1 16.6 10.6 2 4.5 22.4 45.3 0 15 30 45 60 75 Always Most of the time Sometimes Rarely Never Never used a condom Frequency of condom use (%) Transport worker Male laborer

40 THANK YOU slides compiled by www.aidsdatahub.org Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge www.aidsdatahub.org if slides are lifted directly from this site