Mumbai disease in far western Nepal: HIV infection and syphilis among male migrant‐returnees and non‐migrants

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Abstract
Objective To measure the seroprevalence of human immunodeficiency virus (HIV) infection and syphilis, and to assess the behavioural risk factors for these infections among migrant‐returnees and non‐migrants in far western Nepal. Methods In April 2001, we recruited 97 male migrant‐returnees and 40 non‐migrants from five rural villages in Doti district where migration to Mumbai is common. For data collection, we conducted a serological examination for HIV and syphilis, and a perception and behaviour survey on HIV and other sexually transmitted infections. Results We found that 11 of 137 men (8%) were positive for HIV infection and 30 men (22%) for syphilis. The respondents, especially the migrant‐returnees from Mumbai, were engaging in risky behaviours such as pre‐ or extramarital sex, and sex with multiple partners, including sex workers. Conclusions This study revealed high HIV and syphilis prevalence among the male migrant‐returnees and non‐migrants in far western Nepal where migration to Mumbai is common. The prevalent behaviours, particularly among the migrant‐returnees, imply urgent needs of the behavioural modification programme in this area to prevent the spread of HIV infection to general population.