India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability of free sterile needles and syringes from needle exchange programs and targeted interventions with harm-reduction messages, HIV risk is primarily associated with risky drug injection practices. Targeted intervention programs must find ways to increase regular access to harm-reduction services and ensure that use of services translates to changed behaviors. This study demonstrates that a large number of IDUs can be enrolled into a prevention study with reasonable rate of follow-up. Thus, this population should be considered for future HIV prevention trials.
Tun, Waimar, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, and Avina Sarna. 2013. "High HIV incidence among male injection drug users in Delhi, India," Research update. New Delhi: Population Council.
Averting HIV Infections Among People Who Inject Drugs: The AVHI Project