Taboos around sexual matters impact on Nepalese women’s sexual health

Unveiling the silence: women's sexual health and experiences in Nepal

Menger LM, Kaufman MR, Harman JJ, Tsang SW, Shrestha DK. Cult Health Sex. 2014 Jul 18:1-15. [Epub ahead of print]

Rising rates of HIV in Nepal signal an impending epidemic. In order to develop culturally appropriate and effective actions and programmes to reduce HIV transmission, it is necessary to understand attitudes, behaviours and norms surrounding sexual networking and safer-sex practices in Nepal. Nepali women are thought to be at increased risk of sexually transmitted infections (STIs) and HIV, sexual violence and exploitation and other sexual health disparities due to cultural scripts limiting access to education, ability to control sexual relationships and acceptability in discussing sex and sexual health. The present study comprises a series of interviews with 25 women living in Kathmandu (13 individual interviews and 2 focus-group discussions) about their knowledge and experiences related to sex and sexual health. Interviews were translated and transcribed and two independent coders conducted a thematic analysis. Overall, the women described sex as primarily a male domain. Sex and sexual health were viewed as taboo discussion topics and formal sex education was perceived as minimally available and far from comprehensive in its scope. This formative study can inform future interventions aimed at reducing the spread of STIs/HIV in Nepal and empowering women on issues of sexual health and well-being.

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Editor’s notes: This paper explores the changing norms towards sexual behaviour and sexual health among a number of Nepalese women in the context of a small but growing, HIV epidemic. The authors present evidence for the growing impact of migration among young people on sexual behaviour both for women who are left behind by migrating partners and for those women who migrate. As discussion of sexual matters is taboo among Nepali women, the authors used a snowball sampling technique in which they asked contacts to recommend other women to be interviewed. The findings revealed that the women had poor sexual knowledge, and what knowledge they had was drawn from some classroom teaching or family and friends. Most of the women’s first sexual experience was during marriage and lack of knowledge about sex affected these first experiences. The women also reported poor knowledge about STIs and HIV, although they were aware that condoms and fidelity can protect against HIV. Alongside this, these women had poor access to sexual health care and family planning. This small study reveals the implications for sexual matters remaining taboo for women, which leave them devoid of information to ensure healthy sexual lives.   

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