Received: 3 June 2019
Accepted: 27 May 2020
First Online: 8 June 2020
Ethics approval and consent to participate
: The survey was ethically approved by the Nepal Health Research Council (Reference number 03/2016) and was carried out according to ethical and human rights standards [CitationRef removed]. All participants gave verbal and witnessed consent before taking part in the study and no information which could identify individuals were collected in the survey. The study used verbal and witnessed consent due to the following reasons: the study highlights important aspects of the health and well-being of key populations such as drug abuse, sexual practices. Some behaviour such as male-male anal sex is highly stigmatized in Nepalese society. The study population frequently suffers from discrimination and marginalization, and their behaviours – drug use or sex work – are often illegal, making it even harder for us to reach them. In these cases, it is not recommended to seek written consent because of the sensitive nature of the research. Study participants may be reluctant or in worst case refuse to participate in the study which could ultimately hamper the feasibility and validity of the study. The Nepal Health Research Council approved verbal witnessed consent to be obtained. Respondents were given a unique ID number to track their participation in the study. Confidentiality was ensured throughout the survey process, and quality control systems for collection of both biological and behavioural data were incorporated into the survey protocol. It was important to retrieve information about younger segments of this population since risk behaviours often start at a young age [CitationRef removed]. The Nepal Health Research Council granted permission to obtain information from respondents below 18 without parental consent since disclosing the sexual behaviour/identity of the respondent to their parents might compromise them and have unknown repercussions for these individuals. Respondents were given counselling before and after clinical test results. Individuals that tested positive for HIV/STIs were given available treatment or referred for further treatment.
: Not applicable.
: The authors declare that they have no competing interests.