1-U=U at government/national level

Government has support for U=U. Right now the process of developing national strategy plan is on which will include U=U. The guidelines and protocols have accepted U=U principal. Some people think that promoting U=U means supporting unsafe sex.

 

2-Sensitization/ Training of ​PLHIVs, community advocates, service providers and/or CBOs ​

It is felt that it is important to involve health care sector and community workers to promote U=U principle. Promoting not only U=U, but also need to include aspect of wellbeing. Some organisations have developed posters for ARV sites.


3-Incorporating U=U messages in relevant community outreach, education info and social media campaigns

Some organizations are planning to start the campaign through social media.

 

4-Country Challenges and Barriers

Stigma and discrimination still pose major barriers for people living with, or affected by, HIV to seek prevention or treatment services.

As far as legal rights go, Nepal is an example of a country that has enhanced and strengthened the rights of many key populations during the past decade, amending discriminatory laws and creating a more favourable environment for people to access HIV services and treatment.

Nepal has become the first Asian country to identify the existence of ‘gender and sexual minorities’ in its constitution. Article 18 (2) of the constitution under Right to Equality states that no discrimination shall be made in the application of general laws on the grounds of origin, religion, race, caste, tribe, sex, physical condition, condition of health, marital status, pregnancy, economic condition, language or region, ideology or on similar other grounds. Therefore, transgender people are Neither criminalized nor prosecuted in the country, nor are same-sex sexual acts criminalized. GoN and UN has also jointly facilitated a baseline study and five-year work-plan and budget for costshared ‘Catalytic Funding’ to scale-up programs for removing human rights barriers, for key populations to access health services. 

At the same time, however, the following kinds of sex work is criminalized in Nepal:

●        Selling and buying sexual services is criminalized

●        Selling sexual services is criminalized

●        Buying sexual services is criminalized

●        Ancillary activities associated with selling sexual services are criminalized

●        Ancillary activities associated with buying sexual services are criminalized

●        Profiting from organizing and/or managing sexual services is criminalized

Further, 

●        Drug use or consumption is specified as a criminal offence

●        Possession of drugs for personal use is specified as a criminal offence  

Despite the fact that Nepal’s Reproductive Health Rights Act 2018 include protective provisions for transgender people and sexual minorities, the above pose barriers to access to services.  

 

 

References

  1. prepwatch.org
  2. Aidsdatahub.org
  3. avac.org
  4. https://www.fhi360.org/sites/default/files/media/documents/linkages-nepal-prep-demonstration-study-april-2020.pdf 
  5. https://unitaid.org/assets/PrEP-innovation-and-implementation-in-Asia-and-the-Pacific-Meeting-Report-2020.pdf
  6. Country progress report - Nepal Global AIDS Monitoring 2019 
  7. National HIV Infections Estimates, 2018, NCASC
  8. National HIV Testing and Treatment Guidelines, 2020, Government of Nepal, Ministry of Health and Population
  9. http://lawsandpolicies.unaids.org/country?id=KHM&lan=en
  10. PrEP innovation and implementation in Asia and the Pacific: Meeting Report, UNAIDS, Unitaid and WHO in association with the Institute of HIV Research and Innovation (IHRI), December 2020  (https://unitaid.org/assets/PrEP-innovation-and-implementation-in-Asia-and-the-Pacific-Meeting-Report-2020.pdf)
  11. Asia-Pacific Regional Expert Group Meeting on Reviewing Implementation of Commitments from the Asia-Pacific Intergovernmental Meeting on HIV AIDS Beyond 2015, ESCAP, 2018 (https://www.unescap.org/events/asia-pacific-regional-expert-group-meeting-reviewing-implementation-commitments-asia-pacific
  12. HIV Self-Testing Strategic Framework A Guide For Planning, Introducing And Scaling Up, WHO, October 2018 (https://apps.who.int/iris/bitstream/handle/10665/275521/9789241514859-eng.pdf)
  13. HIV and AIDS in Asia & The Pacific: Regional Overview (https://www.avert.org/professionals/hiv-around-world/asia-pacific/overview#HIV_testing_and_counselling_(HTC)_in_Asi)
  14. WHO, Unitaid, and UNAIDS meeting on HIV self-testing and innovative testing approaches in Asia and the Pacific Region: Country progress and plans (December 2020)
  15. UNAIDS Data 2020 (https://www.unaids.org/sites/default/files/media_asset/2020_aids-data-book_en.pdf)
  16. What is PrEP? August 2020 (https://focus-cambodia.com/article/what-is-prep/)
  17. WHO and partners urge countries to fast-track implementation and scale-up of HIV self-testing and other innovative HIV testing approaches in Asia and the Pacific, March 2021 (https://www.who.int/news/item/16-03-2021-who-and-partners-urge-countries-to-fast-track-implementation-and-scale-up-of-hiv-self-testing-and-other-innovative-hiv-testing-approaches-in-asia-and-the-pacific