INTRODUCTION:
in south asia’s labor corridors, HIV risk is often mischaracterized as a failure of individual behavior rather than a byproduct of structural exclusion. while migration sustains regional economies, the legal and social "borders" faced by workers create systemic health inequities. this study investigates how the absence of labor protections functions as a primary driver of HIV vulnerability among returnee migrants in bangladesh, nepal, and pakistan.

METHODS:
a systematic desk review and secondary analysis were conducted, synthesizing data from UNAIDS (2020-2024), ILO labor statistics, and national epidemiological reports. using a structural determinants framework, we analyzed the correlation between employment legal status, workplace protections (sick leave/insurance), and HIV service utilization (testing and ART adherence) across five south asian nations.

RESULTS:
analysis reveals that returnee migrants account for a disproportionate share of new HIV diagnoses (e.g., >60% in bangladesh; 41% in nepal), yet fewer than 30% had access to workplace-based health education or insurance abroad. a critical "protection gap" was identified: undocumented status and fear of deportation were more significant barriers to HIV testing than lack of knowledge. furthermore, condom use rates remained below 50% in sectors with high workplace isolation and restricted freedom of movement, suggesting that labor exploitation directly compromises sexual health autonomy.

CONCLUSIONS:
HIV prevention in south asia cannot succeed through clinical interventions alone. addressing HIV requires a "health in all policies" approach that integrates labor rights such as wage protection and non-discriminatory health access into national HIV strategies. protecting the worker is a prerequisite for protecting public health.