web009, I worked for HIV/AIDS prevention in Nepal as a student during my summer break when I was in Kathmandu for holidays...the situation then was dire and now it has just gotten far worse. As far as the reasons for the alarming rate of infections is concerned, there are several: Yes Prostitution (also known as "commercial sex workers") is one of the main reasons for the rise. with regards to Prostitution, women who have been sold to brothels in India and now to various Cabin bar and dance restaurants that littler Thamel are often not allowed to use protection- In Bombay, girls are severely and brutally punished for even asking and it is not unknown that there are several extremely sick people who will leave infected Nepali girls from Indian brothels at the border with Nepal so that Nepal can deal with them Secondly, the Peace keeping force is another very high risk population. There was a time when the Nepal Government gave zero training to Army personnel before shiping them out for peace keeping missions as a result of which several army folks contracted infections while abroad. A Nepali NGO called Women's Inspiration Community based in KTM, was the first and only group that was allowed access to the Army, Police and even the three prisons in KTM (Central Jail, Bhadragol (spelling?) and Mahila Jail) to conduct HIV/AIDS awareness/prevention and support programs at these places. Business men from Nepal who frequently travelabroad are another very high risk population: They go on "business" trips, hire prostitutes, get infected and knowingly or unknowingly come back home to wife, infect her and sometimes the unborn child--this has happened time and time again in Nepal. Intravenous (I.V) Drug Users, an alarmingly high demographic in Nepal are perhaps the higest risk group. "Life Saving and Life Giving" (LALS), another NGO was the only entity in Nepal that I know of that had a needle exchange program where they actively distributed needles to high risk populations. LALS and WICom also started "Prerna", the support group for Nepalese living with HIV/AIDS. Now for the things that need to be done:....where do I start? Government: There is and has always been an utter lack of understanding by the government on the risk of HIV/AIDS pandemic in Nepal. To the best of my knowledge, the Social Welfare Council for years was in the control of the Palace and even though AIDS was already a problem in Nepal, no one paid attention to it. It took AMFAR(American Foundation for Aids Research) comming into Nepal shortly after democracy to get NGO's started to enable them to work on the issue. The government needs to have stiffer penalties for human traffickers, penalties for Indian brother owners who leave infected, helpless women on the borders and start taking notice of the epidemic and pass legislation accordingly. Medical Personnel: I can't tell you about the number of times I have been to the prison/army barracks and homes of people in Nepal when I was working with WICom to take them to the doctor only to have them refuse treatment becuase the patient was HIV positive. There needs to be training as well as penalties imposed against medical personnel in Nepal who refuse treatment just becuase someone is HIV positive. Students/people in general: The prejudice that the general Nepali has about AIDS is so strong that they are not willing to help. As long as they are not infected and don't know of someone who is infected..what do they care?...it's the attitude that needs to get changed and that is going to take years to do. Let me know if you need additional information, I am only too glad to help in any way I can.