Background: Injecting drug use has emerged as an important route for HIV transmission in India. The Government of India currently estimates that there are 200,000 PWID (or IDUs) in India (NACO, 2010), though other studies indicate the numbers could be much higher. Surveillance studies estimate HIV prevalence among PWID at 9.2% (NACO, 2010). Understanding the patterns of drug use and other behaviors by PWID is critical to successful intervention design. India HIV/AIDS Alliance conducted a baseline with PWID in three states (Delhi, Manipur and Haryana) on drug use and behavior patterns, as part of the Hridaya project, the India component of the five-country, Dutch government-funded Community Action on Harm Reduction program. Methods: A cross sectional survey was conducted with PWID in three states 181 respondents were selected through systematic random sampling using client information made available by partner NGOs at selected sites. Data were analyzed using SPSS software. Results: 60% of PWID interviewed have injected drugs for more than 5 years; 32% inject daily and 33% at least once a week in the last 30 days 22% of PWID have injected using needles or syringes previously used by another person. In the last 12 months, 55% of respondents had sexual intercourse with regular partners; 22.9% with casual partners; and 26.6% with commercial sex partners. During last sexual contact, 70% used condoms with regular partners; 64% with casual partners; and 51.7% with commercial sex partners respectively. Of the 100 respondents who disclosed their HIV status, 21% reported being HIV-positive. Conclusion: Unsafe injection practices along with low condom usage are putting PWID at dual HIV risk. These findings support the development of focused prevention strategies that address both injection drug use and sexual behavior as part of Hridaya's harm reduction approach.
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