Bose, Dipak KumarSINGH, BIRENDRA KUMAR2017-12-142017-12-142017http://krishikosh.egranth.ac.in/handle/1/5810037545DOCTOR OF PHILOSOPHY IN PUBLIC HEALTH By BIRENDRA KUMAR SINGH ID.NO.11PHPHLT104 2017 Department of Public HealthAcquired Immune Deficiency Syndrome (AIDS) remains a public health problem of major significance in most parts of the world. The first HIV infection was detected in 1988 in Nepal. Since then HIV and AIDS epidemic has evolved from low to concentrated among “High risk groups” i.e. Injecting Drug Users (IDUs), Female Sex Workers (FSWs), Men having Sex with Men (MSM) and Seasonal labor Migrants. The objective of this study was to find out socio-demographic characteristics, knowledge, attitude on HIV-AIDS among the respondents and assess the types of behavior that places them at risk of contracting HIV-AIDS in Saptari and Jhapa district of Nepal. This was the cross sectional descriptive study carried out among 457 high risk behavior groups (FSWs, MSMs, IDUs and clients of FSWs) who come for treatment at VCT centre of both district. Multi stage sampling was adopted and data were collected using a pre-tested interview schedule. The study reported that (65.21 %) of respondents were comes under urban settlement and (61.49 %) were in 20-30 year age group. The majority of the respondents (70.24 %) were drinking alcohol, (51.20 %) having addiction, (31.29 %) having intoxicating, only (22.98 %) respondents injecting drug without doctor’s prescription and (52.95 %) had RTI problems. The overall level of knowledge regarding HIVAIDS was (42.89 %) medium level, followed by (34.35 %) high level and (22.76 %) low level. Majority of respondents (67.61 %) were partially aware about major mode of transmission. The overall level of attitude towards HIV-AIDS was (45.08 %) medium level, followed by (41.79 %) high level and (13.13 %) low level. Respondents had positive attitude towards seeking of treatment, if get infected HIV-AIDS. Respondents had ii negative attitude towards disclosure of HIV-AIDS, if get infected. High probability of contracting HIV-AIDS were reported among the respondents, who had having intoxicating drugs (82.52%) and who had using alcohol during sexual activity (75.00 %). Practice of addiction, injecting drugs without doctor’s prescription, use of alcohol during sexual activity, negligence to use condom, high frequency of sex with partner per day, early age at first sex, and use of intoxicating drugs were found the major types of behavior that places the respondents at risk of contracting HIV-AIDS. Majority of respondents had encountered the problems of negative response and attitude of family, teacher & society, difficulty in associating with family, stigmatized for being members of a socially marginalized group, depression/committing suicide, discrimination in daily lives, insult/humiliation, hopelessness and RTI/STIs. Majority of the respondents suggested increasing access and utilization of STI services in the upcoming days, providing education and promoting safer sexual practices, empowerment on rights to live a life free from any kind of violence and sexual exploitation. Based on the results of the study and experiences, it seems to conduct different activities as increase the awareness of HIV-AIDS to make high risk behavior groups aware from the comprehensive knowledge of transmission of HIV-AIDS, awareness program to promote safer sexual practices, Prevention programs for consistent use of condom, Free condom distribution programs through NGOs/ health workers/ volunteers to cover the target population etc. A module on HIV-AIDS and high risk sexual behavior to be developed by the Government in consultation with concerned NGOs & INGOs and implements that module through them to enhance knowledge and practices of high risk behavior groups.ennullThesis