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Country Profiles 
Nepal
Nepal
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Country Profile
The first case of AIDS was reported in 1988. Since then, HIV in the country has evolved from “low” to “concentrated” epidemic. As of 2009, national estimates indicate that approximately 64,000 adults and children are infected with HIV, with an estimated overall prevalence of about 0.4% in the adult population (15-49 years old). As of May 2010, a total of 15,783 HIV cases had been reported to the National Centre for AIDS and STD Control (NCASC). Approximately 25% of HIV reported cases involved women with aged 15-49 years. In 2009, 2,600 children aged 0 -14 were estimated to be ‘currently infected’ with HIV.
As in other countries in the region, people who inject drugs (PWID), men who have sex with men (MSM) and female sex workers (FSW) are the groups most at risk with HIV but additional groups have elevated risk of HIV such as seasonal labour migrants. Data from the 2008 Integrated Bio-Behavioral Surveys (IBBS) made modelers to estimate that 1.1 migrants are HIV infected. Seasonal labour migrants had the highest estimated HIV infections although the prevalence among them slightly dropped from 1.9% in 2006 to 1.1% in 2008. About 2.2 to 3% female sex workers are currently infected with HIV across different places in the country. About 3.8% men who have sex with other men are infected with HIV in Kathmandu (2009), whereas the infection load among male sex workers is 5.2%. Of the reported cases, clients of sex workers account for 19% of HIV infections in 2005 and 15% in 2007. Spouses or female partners of migrant workers and clients of sex workers account for 26% of all adult infections. Vulnerability to HIV is also high amongst young people aged 15-24 as 64% of them have yet to acquire comprehensive HIV knowledge.
A 2008 study among Nepali migrants traveling to Indian cities for work found that about 16% of men engaged in high risk sexual behaviours while in India, and frequently visited sex workers..
Similar to other neighbouring countries, scaling up and sustaining programmes at a high level are always a challenge in Nepal. Amongst the most-at-risk populations, male sex workers formed the majority who were tested for HIV and who knew the result. Coverage of voluntary counseling and testing is very low amongst other most-at-risk groups such as migrants, clients of sex workers, PWID, and MSM.