A slender and self-effacing man, Kafle is from Kathmandu, Nepal where he still lives with his parents and two sisters. Dressed in a bottle green suit and looking extremely young--he's 28 years old--Kafle spoke about his battle with drugs.

"I was a good child," he said. "In school I was an average student--jack of all trades, master in none. I enjoyed sports and was a boy scout. I was very sensitive as a child, though I was the only the son in the family." Kafle is very close to his mother, but he has not spoken to his father since an argument 14 years ago, even though they live in the same house.

"When I got my exam results I has failed Nepali, my mother tongue, by one mark," he said. " I lacked one mark and in the rest of the subjects I got first division marks. Because of that all my friends went in college and I was with a group of failures."

During his repeat final year Kafle started taking drugs. He began by smoking cigarettes and marijuana, but gradually moved onto harder drugs. By the time he graduated from school and enrolled in an engineering program he was taking codeine-based syrups, sleeping pills and other tablets. Disinterested in studying further, he dropped out of the program and began part-time work with a Danish scout project.

"I wasn't working very much, but I was earning a little money," he said. "My mom gave me some money too."

This money paid for his drugs as he grew more dependent. Finally in 1995, after his mother convinced him, he entered a drug rehabilitation center. Two months later he was asked to leave the center because the authorities believed he had been taking drugs on the sly. He says he had stopped and remained clean all through his time at the center.

"It was not true, but there was no way of proving it," he said. "I was told that either I had to leave or admit to taking drugs. Since I hadn't I decided to leave, though I didn't want to because I knew I had several other problems."

Committed to staying clean Kafle began work at a five-star hotel as a telephone operator. Working and keeping busy, he stayed off drugs for almost ten months. But then he relapsed.

"That's why I feel sometimes that it's a disease, there's something in a drug addict," he said. "The was something inside me--again I fell back into drugs. There was family pressure, they didn't trust me. I turned to drugs to handle the pressure."

The pills and codeine he had been taking were hard to find, he said. A friend told him about an opiate based pain killer which was "much better than the old drugs." This "better" drug had to be injected and Kafle became an injecting drug user.

Over the next year and half Kalfe was fully focused on finding drugs and taking them. He would take the pain killers as soon as he woke up, requiring them to be functional for the day.

"I quit my job after some time because my first priority was finding drugs," he said. "I was always late at work and I had to leave the job. Things got worse and worse and worse."

One evening he went out in search of drugs, desperate to get a fix. He had always ensured he used clean syringes, knowing that HIV existed and affected injecting drug users. But that day he didn't care about the disease, he just needed drugs. And he took a chance.

In 1996 he decided that he would "finally quit." He went to buy one last fix, for old times sake. Luck wasn't with him and he was arrested in a police raid. After 16 days in custody he was told to either enter a rehab center or go to jail. He chose the former and reentered the rehab center.

"To get back into the center I had to admit to taking drugs the last time I was there," he said. "For three or four days I had to wear a big sign that said "'Liar.'"

Kafle did well in the center and stopped taking drugs. He studied German and started working at the center while he was still a patient. After a few months he got a high fever and found lumps on his legs. The doctor could not diagnose the problem and finally did a blood test. Kafle tested positive for HIV.

"I was not really depressed when I was diagnosed positive because I was reading spiritual book," he said. "I coped with it well. I knew about the disease because I had taken a class about HIV before and it helped me a lot to understand it."

It was still hard to tell the family. His mother had tried time and again to help him, supporting him in a society that ostracizes drug addicts. It took Kafle a long time to tell her, but when he finally did she was very supportive and told him he would be fine. "She told me that I would survive, that I shouldn't worry about anything," he said.

A week after he found out about being positive he also learned he had won a full scholarship to study in Denmark for six months. He decided to take the opportunity and go abroad.

"It was difficult because I was afraid to talk about my status because of possible discrimination," he said. But he told his friends slowly and found a lot of support.

When he came back to Nepal Kafle began working with the Asian Harm Reduction Network, a program aimed at stopping the spread of HIV among injecting drug users. Nepalese government policies do not recognize the need to lower risks for injecting drug users.

"There is only one syringe exchange program in Kathmandu and one methadone maintenance program," he said. "The government is not supporting or recognizing either programs."

Methadone is a synthetic substitute for heroin, available as pills. The maintenance program is aimed at chronic drug users to lower their use of syringes and thus of contracting and spreading HIV.

"Abstinence is one thing," said Kafle. "If I am a drug user who has never been to a rehab center the first step would be to do that. But chronic users who have been in and out of rehab center--for these kind of people they give methadone."

Kafle does not have AIDS yet, and he does not think about being HIV-positive. His focus is on getting the Nepalese government to recognize the needs of injecting drug users and support programs for them.

"Boys, drug addicts, are dying on the streets," he said. "I want to start a hospice for them."

One hospice, one needle exchange program and one methadone maintenance program will not be enough. The AHRN and people like Kafle will have to continue battling the stigma that surrounds injecting drug users. And putting pressure on their governments to acknowledge the needs of these addicts, who are perpetually at risk of contracting another disease--this one deadlier than drugs.