Around 16 million people inject drugs and three million of them are living with HIV infections globally, says a WHO report. Approximately ten percent of new HIV infections are caused by injecting drug use.
In India, there has been significant reduction in overall HIV infections, but according to a report by National Aids Control Organization (NACO), HIV prevalence among injecting drug users (IDUs) is as high as 7.17 per cent, and they are one of the most vulnerable groups.
Northeastern states had been in the forefront with regard to injecting drug use in the past. Manipur and Nagaland remain the states with highest numbers of IDUs. HIV infections among the group has considerably gone down, nonetheless they still remain vulnerable. “About 15 years ago, it (HIV prevalence rate among IDUs) was 40% in Nagaland, but the latest reports show that the new incidence rate has come down to less than 5 %,” says Chenithung Humtsoe, a social worker based in Dimapur and one of the founding members of North East India Harm Reduction Network (NEIHRN).
NEIHRN, currently based in Dimapur, is a conglomeration of several institutions and individuals from the eight states of Northeast, which works towards harm reduction with special focus on IDUs. Formed in 2000, it functions based on three objectives: capacity building, developing knowledge hub, and advocacy. The “uniqueness” of the network as Chenithung states, is its inclusive nature. It includes professionals, NGOs, former drug users, and affected families.
IDUs are categorized under High Risk Groups (HRGs) by NACO and they are covered under Targeted Interventions. However, despite a number of preventive interventions implemented through NGOs and Community Based Organizations (CBOs), challenges linger. “In reality, the numbers of syringes needed by the drug users to take precaution from HIV infection is not adequate,” says Shasikumar Singh, Project Director of NEIHRN. “…So there are sometimes cases of sharing needles and syringes which still needs to be worked out and focused more.” Using unclean or sharing injecting drug equipment is reported to be one of the most efficient ways of transmitting HIV.
Shasikumar also adds that more needs to be done for promoting safer sex practices. “Most of the drug users are from youth population and they are not really sensitized to use condoms,” he admits, while acknowledging that HIV transmission from drug users to others is “really” going down.
Another challenge is the stigmatization of drug users and pressure from anti-drug organizations, which prevent the users from availing harm reduction services. Compared to early 2000, drug users today are more vocal about their needs, according to Shasikumar. “But it does not mean that all of the drug users can come up openly,” he adds. “Some are reluctant…thinking what would they face after they expose themselves to the whole population.”
Apart from financial crunches, shortage of manpower, and other logistics, NEIHRN is confronted with the perception of the general community. “Some of them think like we are promoting youths to do drugs,” Shasikumar states. “That kind of perception needs to be sensitized and we need to make them understand the objective of harm reduction.”
Government has in place various projects to fight HIV/AIDS and its transmission, but it will only be relevant when the masses and especially the vulnerable avail it. Hence, ample awareness, advocacy and sensitization programmes ought to be initiated to achieve success in containing transmissible epidemics like HIV/AIDS.
