AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #366 - Let’s talk about sex: development of a sexual health program for Nepali women
Authors: Presenting Author: Dr. Michelle Kaufman - Johns Hopkins University
Additional Authors: Dr. Jennifer Harman, Ms. Deepti Khati,
Aim: The purpose of this study was to develop a sexual health intervention for Nepali women with the hopes of increasing their knowledge and attitudes towards being knowledgeable about sex and sexual health, increasing their communication with other women (particularly daughters) about sexual health issues, and increasing communication about safer sexual practices with male sexual partners, particularly among married women whose husbands migrate for work.
Method / Issue: Nepal is a country with high political and economic instability and a strong patriarchal system. Statistics about HIV prevalence in Nepal are difficult to attain accurately (Schroeder, n.d.), however with an increasing number of males engaged in migrant occupations and high reports of extra-marital relationships (MOHP, 2007), infection rates are presumed to be rising. Nepali women’s comprehensive knowledge about AIDS is very low, and combined with low social power and sexual agency, Nepali women are at heightened risk for HIV/STI infection. Conducting HIV intervention work in Nepal, given the political, economic, cultural, and language barriers that exist there, can be challenging.
Results / Comments: This study tested the feasibility of conducting such an intervention that would be practical in the challenging Nepali environment. After conducting careful elicitation research, a 3-session intervention was developed based on the information-motivation behavioral skills model (Fisher & Fisher, 1992) of HIV prevention. Eighty-eight women completed a baseline survey and then participated in the 3-session intervention. Results of the baseline data found that women were much more likely to communicate about sex with a female than a male individual, F(1, 83) = 275.63, p < .001. HIV knowledge at the baseline was fairly low (M = 10.60 items correct out of 15), but the more correct answers participants had, the more likely they were to have spoken with another woman about sex (r = .25, p = .02). Interestingly, comfort with discussing sex was negatively associated with actually having ever talked with another female about sex (r = -.24, p = .03).
Discussion: There is clearly a large need for sexual health programs for Nepali women, and this intervention was feasible to implement, despite the political and social climate that could have potentially posed many barriers. Even though this intervention was being tested with well-educated urban women, we found information and confidence about being able to communicate with their partners about sex was lacking, and that they held many myths and misconceptions about sex. While we initially believed that this intervention might be rejected by the community and not of interest to women due to social norms, the response and popularity of the intervention was overwhelming. The first and third author, who conducted the recruitment for this study, had to turn women away due to lack of resources. In several instances, men even contacted the investigators to enroll their wives in the program. This far exceeded our expectations of how positively a large-scale program such as this would be viewed by the community. Conducting this or similar prevention efforts is not only feasible, but much needed in the Nepali context.
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