title: Epidemiology of HIV, programmatic progress and gaps in last 10 years in Nepal.
abstract: OBJECTIVE
  Nepal has made progress with the control of HIV infection in recent years. There have been changes in epidemiology, programme interventions in different population groups, and changes in policies over the last 10 years, particularly in diagnosis and treatment. Therefore, this review was conducted to identify the effectiveness of different interventions/policies in different sub-populations at risk, targeted towards epidemiology and treatment outcomes for those with HIV infection in Nepal.
  
  
  METHODS
  This review was prepared based on a review of published and unpublished documents from the Nepalese HIV infection control programme, published articles in different journals, different survey reports including integrated bio-behavioural surveillance (IBBS) survey reports.
  
  
  RESULTS
  The prevalence of HIV infection among adults in 2014 was 0.20% with a progressive decreasing trend from 2005. The prevalence of HIV infection among injecting drug users (51.7% in 2005 and 6.4% in 2015 in Kathmandu valley) was relatively high in all years as compared to other risk groups. HIV infection prevalence among women attending antenatal clinics was higher in the year 2006 (0.25%) but there was a decreasing trend in the following years to 2015, when prevalence was 0.077%. Although different interventions were conducted to cover key populations at risk, the coverage in some risk population was very low. HIV testing status among the general population was very low (7.5% among males and 2.9% among females) in 2011. Only one-third of HIV-infected individuals were on ART in 2015, although this proportion has increased since 2005. The share of domestic budget among the total expenditure on HIV control program is below 15%.
  
  
  CONCLUSIONS
  There is the need for implementation of control programmes more efficiently and effectively with expanding geographical and population coverage. Surveillance systems should be strengthened to get up-to-date information for evidence-based planning and developing strategies. The domestic budget for HIV control programme should be increased to improve their sustainability.
authors.affiliation: National Centre for AIDS and STI Control , Department of Health Services , Ministry of Health, Government of Nepal.
authors.forename: Tarun
authors.initials: T
authors.lastname: Paudel
authors.affiliation: Communicable Diseases , WHO Country Office for Nepal , Lalitpur , Nepal.
authors.forename: Nihal
authors.initials: N
authors.lastname: Singh
authors.affiliation: Tribhuvan University , Central Department of Microbiology , Kathmandu , Nepal.
authors.forename: Megha
authors.initials: M
authors.lastname: Raj Banjara
authors.affiliation: National Centre for AIDS and STI Control , Department of Health Services , Ministry of Health, Government of Nepal.
authors.forename: Sambhu Prasad
authors.initials: SP
authors.lastname: Kafle
authors.affiliation: National Centre for AIDS and STI Control , Department of Health Services , Ministry of Health, Government of Nepal.
authors.forename: Yadu
authors.initials: Y
authors.lastname: Chandra Ghimire
authors.affiliation: National Centre for AIDS and STI Control , Department of Health Services , Ministry of Health, Government of Nepal.
authors.forename: Bhesh Raj
authors.initials: BR
authors.lastname: Pokharel
authors.affiliation: National Centre for AIDS and STI Control , Department of Health Services , Ministry of Health, Government of Nepal.
authors.forename: Bir Bahadur
authors.initials: BB
authors.lastname: Rawal
authors.affiliation: UNAIDS , Nepal.
authors.forename: Komal
authors.initials: K
authors.lastname: Badal
authors.affiliation: National Centre for AIDS and STI Control , Department of Health Services , Ministry of Health, Government of Nepal.
authors.forename: Madhav
authors.initials: M
authors.lastname: Chaulagain
authors.affiliation: WHO Regional Office for South-East Asia , New Delhi , India.
authors.forename: Razia
authors.initials: R
authors.lastname: Pendse
authors.affiliation: Communicable Diseases , WHO Country Office for Nepal , Lalitpur , Nepal.
authors.forename: Prakash
authors.initials: P
authors.lastname: Ghimire
keywords: HIV infection; Nepal; control programmes; epidemiology; gaps