Sexual behavior and condom use among seasonal Dalit migrant laborers to India from Far West, Nepal: a qualitative study

PLoS One. 2013 Sep 5;8(9):e74903. doi: 10.1371/journal.pone.0074903. eCollection 2013.


Background: Around 41% of Human Immunodeficiency Virus (HIV) cases in Nepal occur in seasonal migrant laborers. Dalit migrant laborers represent the largest proportion of reported HIV cases in the Far Western Region (Sudur Pashchimanchal, or Far West), Nepal. The study's objectives were to assess sexual behavior, condom use status and HIV risk perception among Dalit migrant laborers to India from Far West Region, Nepal.

Methods: The study was conducted among Dalit male migrant laborers aged 15 years and above who had migrated for at least six months of the last two years to India. For the sampling the village development committees (VDCs) from Achham, Doti and Kanchanpur districts of Nepal were purposively selected. The data were collected in March and April 2011 via ten in-depth interviews and four focus group discussions and analyzed using content analysis.

Results: Poor socio-economic status, caste-related discrimination, and lack of employment opportunities push large groups of young Dalits to migrate to India for employment, where they engage in sex with female sex workers (FSWs). The participants described unmarried status, peer influence, alcohol use, low-priced sex with FSWs and unwillingness to use condoms as common factors of their migration experience. Lack of awareness on HIV/AIDS was common among study participants. Awareness of HIV/AIDS and faithful, monogamous partnerships are reported as factors influencing safer sexual behavior.

Conclusions: Dalits are an especially vulnerable population among migrant laborers and may be over-represented in new HIV infections in Nepal. Comprehensive surveying and health promotion programs targeted to this population are urgently needed and potent methods of stopping HIV spread.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Condoms / statistics & numerical data*
  • Female
  • Focus Groups
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • India / epidemiology
  • Male
  • Nepal / ethnology
  • Poverty
  • Risk-Taking
  • Sex Workers
  • Sexual Behavior
  • Social Class
  • Social Stigma
  • Transients and Migrants*
  • Vulnerable Populations
  • Young Adult

Grant support

The Samata Foundation (Dalit led organization), Lalitpur, Nepal provided funds to conduct this research and helped during data collection. The Samata Foundation had no role in study design or protocol development, data analysis, report writing or the decision to publish this research data in a peer-reviewed article.