The effects of an HIV and AIDS project on migrants in Nepal, Bangladesh and India findings from a quasi-experimental study

Research reports and studies
July 2014
Fiona Samuels, Miguel Niño-Zarazúa, Mirza Manbira Sultana, Prokriti Nokrek, Navneet Kaur, Nabesh Bohidar and Umesh Gahatraj
South Asia is home to 2 to 3.5 million of the world’s estimated 35.3 million people living with HIV and AIDS (UNAIDS, 2013). While HIV prevalence is low among the general population, it is far higher among most-at-risk groups, such as injecting drug users, male and female sex workers and their clients and men who have sex with men, as well as migrants and their spouses.

While mobility itself is not seen as a vulnerabil­ity factor for HIV infection, the unsafe conditions under which people migrate exposes them to a greater risk of infection. Not only do policies and programmes in receiving or host countries hinder migrants from accessing health and social services, but cultural factors and their legal status may contribute to the discrimination they face and act as a further barrier to accessing services. Difficult working conditions, loneliness and feelings of powerlessness, together with peer pressure, may lead migrants to engage in risky sexual behaviours that leave them vulnerable to HIV and AIDS.

Similarly, those left at home may also face loneliness and exclu­sion. They may engage in risky behaviours for live­lihood and survival purposes – particularly if the hoped-for remittances from migrants do not materialise – and can also be exposed to HIV infection by returning spouses or partners who may not be aware of their own HIV infection. In addition, if these source communities are not well tar­geted for HIV and AIDS prevention activities, migrants who come home may well find that their communities are ill-prepared to deal with their potential HIV and AIDS-related needs and vulnerabilities.

This briefing focuses on the situation across three South Asian countries, Nepal, Bangladesh and India.