Are Nepal’s young migrant garment and carpet factory workers vulnerable to HIV?

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.

InNepal, teenagers make up one sixth of all known HIV cases. One third of thetotal numbers of women infected by HIV are young girls. Over two thirds of theworkers in carpet and garment factories are under 24 and most are eitherilliterate or have a low level of education. They may be more likely to engagein high-risk behaviour due to:

• livingin mixed-gender hostels
• peerpressure
• lackof parental supervision
• lowincome
• lackof job security
• exploitationby employers
• isolation and loneliness.

Theresearchers from the Centre for Research on Environment Health and PopulationActivities (CREHPA), Nepal and the Centre for Population Studies, London Schoolof Hygiene and Tropical Medicine, UK, surveyed 1,050 factory workers and took23 in-depth case histories. They found that:

• Onein five boys and one in eight unmarried girls say they have had sex. However, ahigh proportion of sexual debuts take place in villages, before migration tothe Kathmandu Valley.
• Overone in five boys and one in twenty girls reported sex with a non-regularpartner in the 12 months before the survey.
• Friendsfrom the factory are the most recent non-regular sexual partners for all of thegirls and more than 80 percent of the boys.
• Despitea high level of knowledge, reported condom use is very low. About half of theboys and over three quarters of the girls did not use any method of protectionduring the most recent sexual relationships with a non-regular partner.
• Overtwo thirds of the sexually active young factory workers think that they are notat risk of getting HIV and AIDS.
• Themain reasons for young factory workers considering themselves not to be at riskof HIV and AIDS is infrequent sex, believing that their partners do not have otherpartners, thinking that village girls cannot be infected, and having sexualintercourse only once.

Overthree quarters of the boys and four fifths of the girls did not use anycontraception during their first sexual encounter. Nearly 70 percent of thosewho have had sex in the past year think that they or their partner were at riskof getting pregnant. Drawing on these results, the researchers conclude thatprogrammes aimed at promoting safer sex should:

• focuson changing attitudes that create barriers to using condoms
• removemyths and misconceptions and give more detailed information contraception and STIs, especially the message that every sexual act carriesa risk of disease unless condoms are used
• usepeer education and outreach – a preferred source of information among the youngworkers
• target these vulnerable groups with life skillstraining that improves communication and encourages use of reproductive healthservices.