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Injecting and sexual risk behaviours, sexually transmitted infections and HIV prevalence in injecting drug users in three states in India

Mahanta, Jagadisha; Medhi, Gajendra Kumara; Paranjape, Ramesh Sb; Roy, Nandanc; Kohli, Anjaleec; Akoijam S, Brogend; Dzuvichu, Bernicee; Das, Hiranya Kumara; Goswami, Prabuddhagopalc; Thongamba, Gayc; for the IBBA study team

doi: 10.1097/01.aids.0000343764.62455.9e

Objective: To describe and compare sexual and injecting risk behaviours and sexually transmitted infections (STI), hepatitis C virus (HCV) and HIV prevalence in injecting drug users (IDU) in six districts in three states of India: Manipur, Nagaland, and Maharashtra.

Method: The respondent-driven sample consisted of 2075 IDU. Consenting participants were administered a structured questionnaire and samples of blood and urine were collected to test for HIV and STI. Data were analysed using RDSAT.

Results: In two districts in Manipur, 77 and 98% of IDU injected heroin, whereas the main injecting drug in Nagaland was dextropropoxyphene (99%). In Mumbai/Thane, Maharashtra, the majority of respondents reported using chlorpheniramine (87%) and heroin (99%). In all districts, almost half of IDU reported generally sharing needles and syringes; consistent condom use with non-paid female partners was also low. Approximately one-quarter of IDU in Mumbai/Thane visited a paid partner in the past year. IDU with reactive syphilis serology were higher in Nagaland (7 and 19%) than in Manipur and Maharashtra. HIV in two districts of Manipur (23%, 32%) and Mumbai/Thane (16%) was greater than Nagaland (<2%). HCV prevalence was more than 50% in Mumbai/Thane and Manipur.

Conclusion: Irrespective of regional differences, high-risk behaviour of needle sharing and low condom use makes IDU a critical subpopulation for HIV prevention interventions. Interventions need to address the differing drug use patterns in the regions and transmission prevention among non-paid regular and casual female partners of IDU in the northeast districts and paid female partners in Mumbai/Thane.

aRegional Medical Research Centre (RMRC), Dibrugarh, India

bNational AIDS Research Institute (NARI), Pune, India

cFamily Health International (FHI), New Delhi, India

dRegional Institute of Medical Science (RIMS), Imphal, India

eKripa Foundation, Kohima, India.

* Members of the IBBA study team are listed at the end of the paper.

Correspondence to Jagadish Mahanta, Regional Medical Research Centre (RMRC), NE Region, (Indian Council of Medical Research), Post Box No. 105, Dibrugarh 786 001, Assam, India. E-mail:;

© 2008 Lippincott Williams & Wilkins, Inc.