The growing textile industry in Nepal’s Kathmandu Valley attracts large numbers of young rural migrant workers. Away from home, are they vulnerable to rising epidemics of sexually transmitted infections (STIs) and HIV? Researchers investigated the behaviours and perceptions of risk among migrant workers aged 14 to 19 years.

In Nepal, teenagers make up one sixth of all known HIV cases. One third of the total numbers of women infected by HIV are young girls. Over two thirds of the workers in carpet and garment factories are under 24 and most are either illiterate or have a low level of education. They may be more likely to engage in high-risk behaviour due to:

• living in mixed-gender hostels
• peer pressure
• lack of parental supervision
• low income
• lack of job security
• exploitation by employers
• isolation and loneliness.

The researchers from the Centre for Research on Environment Health and Population Activities (CREHPA), Nepal and the Centre for Population Studies, London School of Hygiene and Tropical Medicine, UK, surveyed 1,050 factory workers and took 23 in-depth case histories. They found that:

• One in five boys and one in eight unmarried girls say they have had sex. However, a high proportion of sexual debuts take place in villages, before migration to the Kathmandu Valley.
• Over one in five boys and one in twenty girls reported sex with a non-regular partner in the 12 months before the survey.
• Friends from the factory are the most recent non-regular sexual partners for all of the girls and more than 80 percent of the boys.
• Despite a high level of knowledge, reported condom use is very low. About half of the boys and over three quarters of the girls did not use any method of protection during the most recent sexual relationships with a non-regular partner.
• Over two thirds of the sexually active young factory workers think that they are not at risk of getting HIV and AIDS.
• The main reasons for young factory workers considering themselves not to be at risk of HIV and AIDS is infrequent sex, believing that their partners do not have other partners, thinking that village girls cannot be infected, and having sexual intercourse only once.

Over three quarters of the boys and four fifths of the girls did not use any contraception during their first sexual encounter. Nearly 70 percent of those who have had sex in the past year think that they or their partner were at risk of getting pregnant. Drawing on these results, the researchers conclude that programmes aimed at promoting safer sex should:

• focus on changing attitudes that create barriers to using condoms
• remove myths and misconceptions and give more detailed information contraception and STIs, especially the message that every sexual act carries a risk of disease unless condoms are used
• use peer education and outreach – a preferred source of information among the young workers
• target these vulnerable groups with life skills training that improves communication and encourages use of reproductive health services.

Source(s):
‘Sexual behaviour and perceived risk of HIV/AIDS among young migrant factory workers in Nepal’, Journal of Adolescent Health 38, pages 237-246, by M. Puri and John Cleland, 2006
HINARI subscribers can access the full-text article here. Full document.

Funded by: The Wellcome Trust

id21 Research Highlight: 6 October 2006

Further Information:
Mahesh Puri
Center for Research on Environment health and Population Activities
(CREHPA)
Kathmandu
Nepal

Tel: 977 1 5546487 or +977 1 5521717
Fax: 977 1 5522724
Contact the contributor: mahesh@crehpa.wlink.com.np

Centre for Research on Environment Health and Population Activities (CREHPA), Nepal

Centre for Population Studies, London School of Hygiene and Tropical Medicine, UK

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