Coping with HIV and dealing with the threat of impending death in Nepal

Abstract

The number of people living with HIV is increasing in Nepal. While efforts have been made to measure the number of people affected by HIV and trends in the epidemic, little is known about how people with HIV perceive their disease, and how they cope on a day-to-day basis. The study also highlights the role of counselling and a variety of support systems. A grounded theory approach was used to explore the life experiences of people living with HIV in Nepal. A detailed study of 20 participants was undertaken. The participants experienced immediate and long-lasting psychosocial effects of HIV which included a prolonged 'death phobia' and heavy burdens of care. Particularly for women, the issues associated with decreasing health and fear of death was severe. A HIV positive diagnosis led some men to take fatalistic approaches, such as using drugs and alcohol to cope with HIV, whereas some women attempted suicide. Counselling and interactions between people with HIV and their HIV positive peers helped to overcome adverse psychosocial consequences and to cope with HIV.

Prison, a missing target to address issues related to drug detoxification and rehabilitation: Nepalese experiences

“…The basic social processes are interrupted for such families; for example, other community members might refuse to marry any members of that family or invite such families to attend parties or rituals. In many ways, the family of a drug user or a drug user with HIV is alienated socially and culturally Madison, 2009, 2012;Jha et al, 2011). This range of issues and burdens associated with drug use underscores the importance of successful detoxification to minimize these consequences.…”

“…A large number of young people drop out from schools and young parents cannot afford the cost of educating their children, as they have used money to purchase drugs (Jha, 2006;Jha and Madison, 2009). Breakdowns in relationships are common among young people due to drug use (Jha et al, 2011). Culturally, many youths marry within the age of 20-25 years (CBS, 2004).…”

“…The financial and caring burden can increase for elderly parents if their sons and daughters use drugs. In such cases, the parents are obliged to look after and educate any grandchildren and also support their daughters-in-law, if the latter do not earn an income (Jha, 2006;Jha and Madison, 2009;Jha et al, 2011). Elderly parents assuming these financial burdens and covering the expenses of their children and families is a part of family tradition, which prevails by and large in Nepal (Bennett, 2002).…”