A disproportionate number of street children use and inject drugs and engage in survival sex as coping mechanisms. This study aimed to determine the prevalence of drug use, injecting drugs, survival sex, and condom use and determinants associated with these behaviors among street children. Cross-sectional surveys were conducted in 2016 with an aim to sample 350 street children and youths in Kathmandu Valley, Nepal. Information about sociodemographic characteristics, injecting drugs, sexual risk behaviors, and biological specimens for HIV testing were obtained. The logistic regression model was used to identify the determinants associated with drug use, injecting drugs, survival sex, and condom use during last sex. Variables that were significantly associated with being a current drug user (versus never) in the presence of other variables included being a rag picker (adjusted odds ratio [AOR] = 3.2; 95% confidence interval [95% CI] = 1.73-5.9), history of imprisonment (AOR = 2.21; 95% CI = 1.21-4.04), alcohol consumption (AOR = 2.66; 95% CI = 1.46-4.84), and solvent sniffing (AOR = 5.12; 95% CI = 2.74-9.59). Variables that were significantly predictive of injecting drugs (versus never) in the presence of other variables include being 17 years old (AOR = 3.42; 95% CI = 1.11-10.55) and being a rag picker (AOR = 3.5; 95% CI = 1.25-9.75). Variables that were significantly associated with having survival sex (versus never) in the presence of other variables include being 17 years old (AOR = 3.58; 95% CI = 1.31-9.81) and having forced sex (AOR = 9.62; 95% CI = 3.21-28.8). Drug use and survival sex are major coping mechanisms among street children in Kathmandu Valley and are associated with many risk behaviors. Targeted programs should be implemented to meet their special needs.

Introduction: Infertility is being a common global problem affecting one couple in six. Approximately 167 million ever married women aged 15-49 years in developing countries were infertile. The problem of infertility has not given attention considering the fact that it is not the life threatening, but, it has substantial community health problems such as depression, anxiety domestic violence and social isolation. The purpose of the study was to explore the causes of infertility among couples who visited the infertility centre. Methodology: Hospital based descriptive cross-sectional study had been carried out in infertility centre Kathmandu Nepal. One hundred and sixty five married couple with infertility problem availing the infertility treatment was selected on first come first serve basic sampling method from infertility treatment centre. Result: The infertility problem varied with the age. The problem was highest among the females of age group 26-30 years (51%), similarly in males it was predominant at the age of 31-35 years (45%). The most common causes of female infertility were ovarian cyst (37%) and heavy bleeding (18.7%), uterine fibroids (9%), Pelvic inflammation (9%), Thyroid disease (21.8%), whereas in males the infertility were mostly due to Oligospermia (17.5%), Azoospermia (5.5%), Hydrocele (7.8), Mumps orchids (6%). Conclusion: Infertility was due to various causes in the male or/and the female partner, however, the infertility among couples were mostly due to the problem in females. Infertility is a complex problem that should be considered carefully by the individual, community peoples, government and stakeholders in each country.

Introduction: HIV epidemic has become the major problems among people with injecting drugs (PWIDs) in Nepal. The study was carried out to assess the prevalence of sexually transmitted diseases including HIV/AIDS among PWIDs. Methods: This descriptive cross-sectional survey was conducted in male PWIDs of age more than 16 years residing in Western to Far West Terai Districts of Nepal who had been injecting drugs for three months prior to the date of the survey" March-April 2017. A two-stage cluster sampling was used to recruit 300 PWIDs from seven Districts. HIV was diagnosed by using standard techniques approved by WHO. Similarly, Syphilis was tested using the "Rapid Plasma Reagin" and Hepatitis C as well as Hepatitis B was tested by using rapid test kits. Demographic data were collected by using structured questionnaire and the data obtained were entered in MS excel was transformed into the SPSS version 21 for the descriptive as well as inferential analysis. Results: Prevalence of HIV, HBV, HCV, and STI among PWIDs were 5.3%, 2.7%, 23.7%, and 2.0% respectively. Majority of the PWIDs were literate (93.7%) and their age was below 35 years. Among the married PWIDs, 32.4% had got married before the age of 19. Similarly, 53.7% of them were living with their female sexual partner, and 95.0% were living with their wife. Ninety six percent of the respondents reported to be ever involved in sexual activity, 77.1% of them initiated the sexual intercourse before the age of 20 years and 41.9% of them had more than one female sexual partner. The survey indicated that 36.3% had been injecting drugs for more than 5 years while 27.7% had been injecting for last 2-5 years and 55.0% of the respondents had injected for the first time at the age of 16-24 years. About one in 10 respondents had started injecting drugs recently. Conclusion: There is high prevalence of HIV, HCV, HBV and active syphilis among the PWIDs. Co-infection of HIV and HCV as well as Hepatitis B and C were also prevalent among PWIDs. Comprehensive education and awareness program is required to reduce the prevalence.