My first time: initiation into injecting drug use in Manipur and Nagaland, north-east IndiaReportar como inadecuado

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Harm Reduction Journal

, 4:19

First Online: 05 December 2007Received: 03 July 2007Accepted: 05 December 2007


BackgroundThe north-east Indian states of Manipur and Nagaland are two of the six high HIV prevalence states in the country, and the main route of HIV transmission is injecting drug use. Understanding the pathways to injecting drug use can facilitate early intervention with HIV prevention programs. While several studies of initiation into injecting drug use have been conducted in developed countries, little is known about the situation in developing country settings. The aim of this study was to increase understanding of the contextual factors associated with initiation into injecting drug use in north-east India, and the influence of these factors on subsequent initiation of others.

MethodIn mid 2006 a cross-sectional survey among 200 injecting drug users IDUs was undertaken in partnership with local NGOs that provide HIV prevention and care services and advocacy for IDUs in Imphal, Manipur and Dimapur, Nagaland. The questionnaire elicited detailed information about the circumstances of the first injection and the contexts of participants- lives. Demographic information, self-reported HIV status, and details about initiation of others were also recorded.

ResultsInitiation into injecting drug use occurred at 20 years of age. The drugs most commonly injected were Spasmo-proxyvon 65.5% and heroin 30.5%. In 53.5% cases, a needle belonging to someone else was used. Two-thirds 66.7% had used the drug previously, and 91.0% had known other IDUs prior to initiation mean = 7.5 others. The first injection was usually administered by another person 94.5%, mostly a friend 84.1%. Initiation is a social event; 98% had others present mean = 2.7 others. Almost 70% of participants had initiated at least one other mean = 5 others. Initiation of others was independently associated with being male and unemployed; having IDU friends and using alcohol around the time of initiation; and having been taught to inject and not paid for the drug at the time of initiation.

ConclusionTargeting harm reduction messages to non-injecting drug users and capitalising on existing IDU social networks to promote safe injecting and deter initiation of others are possible strategies for reducing the impact of injecting drug use and the HIV epidemic in north-east India.

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Autor: Michelle Kermode - Verity Longleng - Bangkim Chingsubam Singh - Jane Hocking - Biangtung Langkham - Nick Crofts


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