Nepal Hot Spot Mapping

Title: Nepal Hot Spot Mapping
Principal Investigators: Sujan KarkiHeather Cogswell, Marianne El-Khoury 
Timeline: Round 1 (2017), Round 2 (2019)


Global HIV prevention efforts have long focused on “high risk” groups, such as sex workers, whose activities put them at increased risk of HIV infection. HIV in Nepal is a concentrated epidemic, with higher levels of HIV among key affected populations, notably people who inject drugs, men who have sex with men, transgender people, sex workers (male and female), and male labor migrants and their spouses. In Nepal, the Ministry of Health estimates that between 0.4 percent and 2 percent of the female population engages in sex work. HIV prevalence among female sex workers is approximately 2 percent, 10 times higher than in the general population. The SHOPS Plus program in Nepal supports the Nepal Contraceptive Retail Sales Company (CRS) to increase use of condoms among sex workers and their clients by strengthening CRS’s capacity for evidence-based condom promotion and distribution in “hot spots,” locations where transactional sex takes place or is negotiated for in the areas where CRS works. This study measures condom accessibility and availability near these areas through mapping hot spots and condom-selling outlets in nearby areas.

Objectives/research questions:

The study objectives are to:

  1. Map hot spots and hot zones in the Kathmandu Valley in Nepal. "Hot zones" are defined as areas within a 100m radius of hot spots, which are specific locations (i.e. hotels, bus parks) where transactional sex occurs or is negotiated for.
  2. Map retail outlets that sell condoms in hot zones
  3. Assess condom availability for both CRS and non-CRS brands
  4. Assess condom accessibility for both CRS and non-CRS brands
  5. Collect basic information on outlets in hot zones (e.g. operating hours, employee age, sex, and education level)


In the first phase of the study, data collectors conducted field work to identify areas where transactional sex takes place or is negotiated for, called hot spots and hot zones. This information was used to create a GIS map of hot zones in CRS’s supervision areas. In the second phase of this study, SHOPS Plus and CRS mapped all condom-selling outlets in all hot zones. In the third phase, SHOPS Plus and CRS used Lot Quality Assurance Sampling and conducted a retail audit to assess condom availability and accessibility in a sample of 19 hot zones in each of CRS’s six supervision areas. Outlets included pharmacies, paan/cigarette shops, grocery stores, and general stores. 

CRS uses this information to inform its condom marketing and distribution strategies in hot zones. SHOPS Plus will repeat the third phase of this study, the retail audit in outlets in selected hot zones, on an annual basis in order to continuously monitor condom availability and accessibility in hot zones and to inform CRS’s program management decisions.

Status: Rounds 1 and 2 complete
Date of last update: November 2019

Learn more about our work in Nepal and pharmaceutical partnerships and social marketing.

See other SHOPS plus studies. 



Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AID-OAA-A-15-00067) funded by the United States Agency for International Development (USAID). This website is made possible by the generous support of the American people through USAID. The information provided on this website is not official U.S. government information and does not represent the views or positions of USAID or the U.S. government.