Inter Press Service - October 8, 1999
Ramyata Limbu

Wary visitors entering Prerana's modest premises are instantly put at ease. A handwritten notice on the wall reads: "Our goal is to enable people living with HIV/AIDS and their families to live dignified and fulfilling lives without fear of prejudice or discrimination in society."

"All are positive, all are negative within these four walls," says Deepak Devkota, an outreach worker with Prerana since 1997.

A former drug addict, Devkota, 30, holds HIV prevention classes in schools in and around Kathmandu, the Nepali capital. He addresses students, their parents and teachers and shares his experience at workshops and seminars.

"I make home visits, talk to the families of people living with HIV/AIDs, try to make them understand that these people require love, care and support and should not be looked at with disgust. I try to increase their understanding about HIV/AIDs," says Devkota.

The outreach worker, who knows the city s alleys and drug pockets like the back of his hand, takes pains to get through to drug addicts - identified as a high risk group.

"It's easy to spot an addict or a person with AIDS," says Devkota.

"Talking to them, convincing them about the dangers of sharing needles is harder. Often they have suspicions about having contracted the virus but are afraid to seek help. I try to convince them to take a blood test. Or to talk to peer educators and counsellors at Prerana."

At the support group's premises in Kathmandu, people are welcome to drop in for a game of chess or carroms, sometimes partake in a meal or to just talk and be with peers who don't care about their HIV status.

Despite the AIDS hype and the millions spent on prevention and awareness campaigns, support for people with HIV/AIDS is sorely lacking.

The stigma attached to the disease makes it difficult for people to seek help. Prerana's hotline service, operating since July 1998, tries to fulfill that gap by providing confidential information and counselling to callers.

"People usually ask about the time it takes for HIV to develop into AIDS, where to take a blood test, or about HIV/AIDS symptoms," says Sita Bogati, a hotline counsellor.

"Calls range from the personal to the medical. Concerned wives call about their husbands and how to ensure that they take a test.

Husbands who have contracted the virus ask about ways to protect their wives and children and queries about the safety of condoms in preventing HIV/AIDs are quite common, she said.

As of May 1999, a total of 256 AIDs cases and 1287 HIV positive cases were reported to the Ministry of Health's National Center for AIDS and STD Control. Surveys indicate that the majority of people with HIV/AIDs are sex-workers and their clients followed by injecting drug users. More than fifty per cent fall within the productive age group of 20-29.

No specific studies are available to estimate how incomplete or inaccurate the Ministry's reports may be, given the existing medical and public health infrastructure and the limited HIV/AIDS surveillance system in place in Nepal. However, there are indications that the actual number of AIDS cases that have occurred could be at least 5 to 10 times the reported number and the actual HIV prevalence at least 20 to 30 times greater.

By the year 2000, the cumulative prevalence of HIV infections is projected to be 25,000 cases and the cumulative total number of AIDS cases close to 5000. First detected in Nepal in the 1988, the potential for the spread of HIV in Nepal is considered high because of a large number of commercial sex workers, high rate of STDS, low condom use and pockets of intravenous drug users.

While the WHO-supported National AIDs and Prevention Control Project and the National Center for AIDS and STD Control screen blood samples, develop educational material, treat STDs, and train health workers, such organizations do little to provide emotional and peer support.

"Prerana tries to fulfil that need," says a 24- year-old peer educator. " Sometimes clients come with high expectations liek a place to live, meals, good care without prejudice and doctors who won't treat them like dirt. When we can't provide all that, they become frustrated." the educator said.

Prerana, registered as an NGO in March 1998, was started as a small support group by three people - two housewives and an odd- job man all of whom were HIV positive.

"We used to meet informally for the first four or five years," says 35-year-old Sharan Chettri founder member of Prerana.

A counsellor with the organization, Chettri recently married Asha, another founder member. A garlanded photo of Kopila, a third founder member occupies a special place on the office wall.

Kopila succumbed to the virus last year. Chettri, a former addict, doesn't know how long he has left himself but would like to see Prerana grow into a bigger, stronger, more effective support group.

"Coming out into the open, letting people know that I was HIV Positive was a big step. Initially I was afraid. But I wanted people to become aware, learn from my experience," says Chettri, who between bouts of illness, visits Prerana to offer counselling. (END/IPS/rl/rdr/99)
991008
IP991002

Always watch for outdated information. This article first appeared in 1999. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1999. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .