The Population Council is generating evidence and piloting new approaches to prevent HIV infections among people who inject drugs in India.
India has one of the largest populations of people who inject drugs (IDUs) in the world. Because HIV is easily transmitted through needle-sharing and other injecting practices as well as risky sexual practices, IDUs have a disproportionately high risk of HIV infection. Their sexual partners are also at risk, even if they do not engage in injection drug use.
To date, HIV prevention efforts with IDUs in India have primarily focused on reducing injection-related risks, with less emphasis on sexual risk.
The Averting HIV Infections Among IDUs (AVHI) project seeks to prevent HIV transmission among people who inject drugs and their sexual partners by providing the comprehensive package of prevention, treatment, and care of HIV in relation to drug use developed by the World Health Organization, the United Nations Office on Drugs and Crime, and UNAIDS. The comprehensive response includes needle exchange, HIV counseling and testing, and condom provision for people who inject drugs and their sex partners.
The Population Council’s evaluation of AVHI has documented HIV prevalence and incidence among people who inject drugs in Delhi, behavioral correlates of HIV infection, Hepatitis B and C prevalence and their co-infections with HIV, and strategies to recruit people who inject drugs into an HIV prevention intervention. The project is also examining the drug-use behaviors of noninjecting female drug users and implications for health-seeking behaviors. It is the first evaluation of the effectiveness of the recommended comprehensive package of HIV prevention for IDUs in India. The evaluation will provide a more complete evidence base to inform future HIV prevention interventions.
AVHI’s findings have been provided to the Government of India in order to help shape national HIV policies and programmatic responses to people who inject drugs. They will also provide lessons learned on the implementation of comprehensive HIV prevention programs.