Public Health - International Health
Human Rights Violations and HIV Related Outcomes among Men who have Sex with Men in Nepal
Relationships between exposure to human rights violations and health behaviors and outcomes have not been adequately examined. Consideration of the human rights dimension is necessary for a more complete understanding of the complex interaction between HIV related risk behaviors and societal, community, relationship, and individual factors. We aim to determine the association between human rights violations and HIV related health behavior among men who have sex with men in Katmandu, Nepal. Methods: Formative phase activities (focus group discussions and modified Delphi technique) will identify a range of locally relevant human rights violations explicitly protected in human rights covenants (e.g. torture, legal discrimination or discrimination at home/workplace due to sexual orientation), and will guide development of context-appropriate survey instrument. Trained peer interviewers will administer the survey among a sample of 754 men who have sex with men selected through respondent driven sampling. Prevalence of human rights violations and HIV related health behaviors (unsafe sexual practices, injecting drug use) and self-reported health outcomes (sexually transmitted diseases, HIV status) will be estimated. Standard regression techniques will be used to compare HIV related health behaviors and outcomes by exposure to rights violations. Significance: The study will provide quantitative estimates of the association between human rights violations on HIV related behavior among men who have sex with men and third genders in Nepal, foster research partnerships between local and international organizations and provide preliminary data for future rights based interventions to decrease HIV related risk behavior among MSM and third genders in Nepal.
Sonal Singh, MD MPH Medicine Medicine (GIM, Appt Pending)