Despite government efforts to control the spread of HIV among drug users through infected needles, cases of such infections have increased in the last three years. The number of HIV cases caused by infected syringes and needles rose by about 13% in 2016-17 over the previous year, data from the ministry of health and family welfare shows.
In 2014-15, the country recorded 3,518 cases of HIV infections due to needles. In 2015-16, the number rose to 3,542, while in 2016-17 around 4,011 cases were recorded.
The data is based only on information about needles and syringes as the source of HIV, as reported by individuals during pre- and post-test counselling at integrated counselling and testing centres across the country. The authorities claim that the number may be much higher than this, as many cases either go undetected or are treated by private sector facilities.
“One of the mandates of the government’s AIDS control programme is to focus on high-risk groups such as those taking drugs by needles. The model of screening and counselling has been successful and we have been able to help many such patients who got HIV through drug injecting needles,” said a senior official of the National AIDS Control Organization (Naco ) on condition of anonymity.
“Our counsellors remain in constant touch with these drug users and try to enrol in the de-addiction programme but the challenge is their high-risk behaviour. They share the syringes and become highly susceptible to HIV infections which is impeding our progress in containing HIV infections in this group,” the official added.
The World Health Organization (WHO), United Nations Office on Drugs and Crime (UNODC), and United Nations Programme on HIV/AIDS (UNAIDS) recommend a comprehensive package for prevention, treatment, and care of HIV infections among people who inject drugs (PWID). Such people continue to engage in unsafe injection and unprotected sex, resulting in new infections, highlighting the need for continued focus on HIV prevention while providing care services for HIV-positive PWID, according to experts.
The Population Council, an international non-government organisation, in collaboration with the New Delhi-based Sahara Centre for Residential Care and Rehabilitation, launched the “Averting HIV infections” (AVHI) project for PWID in Delhi in 2014, as part of an HIV incidence study. The study found that HIV prevention in drug users’ treatment and care is a challenging task due to a number of reasons.
A group of 3,774 PWIDs were enrolled for a prospective HIV incidence study and provided with the comprehensive package i.e. HIV and hepatitis testing and counselling, Hepatitis B (HB) vaccination, syndromic management of sexually transmitted infections, clean needles-syringes, condoms, abscess care, and education.
The PWID were also referred to government services for antiretroviral therapy (ART), tuberculosis care, opioid substitution therapy, and drug dependence treatment and rehabilitation. Of the HIV-positive clients, only 17.8% registered for ART services after repeated follow-ups. Reasons for not seeking ART services included not feeling sick, need for multiple visits to the clinic, and long waiting times.
India has a large PWID population estimated at 177,000 with an estimated HIV prevalence of 7.2%.