Double trouble: Injection, drug use and sexual behaviour in India

People who inject drugs (PWID) in India and elsewhere face a disproportionally high risk of contracting HIV and other blood borne viruses. India is home to at least 180,000 PWID, a large proportion of whom do not have access to sterile injecting equipment which in turn results the use of non-sterile needles and syringes and consequent rapid and large-scale transmission of HIV.

The prevalence of HIV among PWID in some states is estimated to be as high as 15%. In order to prevent new HIV infections, the National AIDS Control Organisation (NACO) has adopted a harm reduction strategy implemented under the National AIDS Control Programme IV. The strategy sets out a range of interventions, called Targeted Interventions, which are implemented by NGOs to reach PWID. With funding from Government of the Netherlands through the Community Action on Harm Reduction Initiative, Alliance India’s Hridaya programme operates in the states of Bihar, Haryana, Jammu, Manipur, and Uttarakhand and delivers a range of interventions that supplement the NACO-supported programme.

The current research is one of the first qualitative comparative studies to seek an in-depth understanding of the vulnerabilities to HIV acquisition among PWID in the states of Manipur and Bihar. The study also aims to describe the factors that influence vulnerability to sexual transmission of HIV between PWID and their sexual partners. Additionally, the study focuses on logistical issues associated with the delivery of various harm reduction services to PWID and their sexual partners, as the quality of services offered to these groups has not been adequately documented in the past.

By better understanding service gaps and additional needs of PWID, we hope this study will contribute to the expansion of appropriate interventions for PWID and their sex partners under the National AIDS Control Programme.

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