HIV risk is determined by the interaction between social and individual risk factors,
but information about such factors among Nepalese women is not yet understood.
Therefore, to assess the risk factors and vulnerability of the wives of Nepalese labor
migrants to HIV infection, we conducted a mixed-methods study in which a
descriptive qualitative study was embedded within a case-control study. We
interviewed 224 wives of labor migrants in the case-control study, and conducted two
focus group discussions (n=8 and 9) in the qualitative study. We found that illiteracy,
low socio-economic status and gender inequality contributed to poor knowledge and poor sexual negotiation among the wives of labor migrants and increased their risk of
HIV through unprotected sex. Among male labor migrants, illiteracy, low socio-
economic status, migration to India before marriage and alcohol consumption
contributed to liaisons with female sex workers, increasing the risk of HIV to the men
and their wives through unprotected sex. Both labor migrants and their wives feared
disclosure of positive HIV status due to HIV stigma and thus were less likely to be
tested for HIV. HIV prevention programs should consider the interaction among these
risk factors when targeting labor migrants and their wives.