“No one should suffer in silence”

How community care is restoring dignity, trust and hope in Nepal’s HIV response

May 15, 2026

Photograph of a woman in red sari seated in doorway of blue-walled hut with brick triangle mural. — Sitting in the front porch of her rural home in Dhanushadham,Ram Prasad Sada shares her journey of resilience as a transgender woman living with HIV.

Photo: UNDP Nepal

Draped in a red saree with matching bangles stacked on her wrists and a ribbon of the same colour tied in her hair, Ram Prasad Sada (now Parichan) greets visitors with a calm smile and quiet dignity from the front porch of her room.

A few months ago, at a safe home centre in Janakpur district, the 34-year-old transgender woman spoke openly for the first time about living with HIV for the last fifteen years.

“It wasn’t like this before, people avoided me and called me names once they learned I had HIV. I was scared to get tested as I thought if people found out, I would lose everything — my family, my work, my dignity.”

Ram Prasad Sada, Beneficiary

A space without judgement

That changed when a peer outreach worker encouraged her to visit the Sunaulo Bihani Samaj community office in Janakpur. Speaking publicly about her experience took a lot of courage, but what she found was acceptance and ample support.

Photograph of two women in colorful sarees and a man at a table playing chess. — Jayanath Yadav and Ram Prasad Sada engage in a discussion on treatment and community outreach at the Sunaulo Bihani Samaj office.

Photo: UNDP Nepal

For many people facing stigma, support from someone with lived experience is often the first step toward seeking treatment. At the centre, met other transgender women receiving counselling, treatment and peer support in an environment built on trust and respect.

“When I saw others living healthy and proud, I told myself I could do it too,” she says. “If they could rebuild their lives, I believed I could rebuild mine too.”

Group of people in colorful traditional clothes sitting in a circle on the grass in a park. — Members of the transgender community gather to share experiences, discuss treatment, and strengthen one another through solidarity and trust.

Photo: UNDP Nepal

Encouraged by peer outreach worker, Ram Prasad was linked to ART Center supported by the National Center for AIDS and STD Control (NCASC), where she initiated her antiretroviral therapy (ART) and continues to receive regular follow-up care and psychosocial support. She has been in treatment for several years now and her health has considerably improved.

Community-led care

Today, Ram Prasad is not only managing her own health but also supporting other community people who face the same fears she once carried.

Close-up of hands holding a white medicine bottle outdoors. — ART drugs suppress the virus, strengthen immunity, and enable people living with HIV to lead long, healthy lives.

Photo: UNDP Nepal

Working with community leaders in Dhanusha and nearby areas, she raises awareness on HIV prevention, encourages testing and treatment, and helps people stay on ART.

Ram Prasad Sada’s journey reflects a broader shift across Nepal: a move toward community-led HIV services that bring care closer to those who need it most.

“I want others to know they deserve care, respect and a healthy life,” she says. “No one should suffer in silence.”

Ram Prasad Sada, Beneficiary

Supported through the UNDP-implemented Global Fund programme, local organisations including Blue Diamond Society and Sunaulo Bihani Samaj are strengthening peer outreach, safe spaces, home-based care and rights-based health services for transgender people (or SGM ), migrants and their spouses, and people who use drugs.

By working directly through communities, these efforts are helping remove barriers of stigma and discrimination that often keep people away from formal health systems — ensuring prevention, testing, treatment and psychosocial support are more accessible and trustworthy.

Two people, a man and a woman, sit on a pink floor facing each other with a small white dog between them. — Jaynath Yadav sits in thoughtful consultation with Satya Narayan, discussing community-led efforts under UNDP's Global Fund Programme.

Photo: UNDP Nepal

Beyond the numbers

In 2025 alone, community outreach reached more than 412,000 people from key populations. Over 327,000 people received HIV testing, while nearly 380,000 were screened for tuberculosis alongside HIV services.

Beyond expanding access, community-led monitoring and advocacy are improving the quality, accountability and inclusiveness of HIV services across Nepal.

Photo of a blurred-faced person in a red robe, sitting cross-legged in a doorway beside bucket. — With support from Sunaulo Bihani Samaj, she continues her ART treatment with confidence and now encourages others in her community to seek care without fear or stigma.

Photo: UNDP Nepal

As the country works toward ending HIV as a public health threat by 2030, National Center for AIDS and STD Control (NCASC), UNDP and its partners continue to strengthen outreach and deepen understanding of evolving risks among key populations, including people who inject drugs and migrant workers.

For Ram Prasad, however, the impact of community-led care cannot be captured in numbers. What changed her life was not only medicine — but being seen, heard, and treated with dignity.