HIV and Drug Abuse in India

Prescription drugs like the opiate pethidine have replaced cannabis and heroin as the drugs of choice among young people in India. Most teenagers start with cannabis before moving to opiates and prescription drugs. The reason is the easy availability of prescription drugs.

Sharing needles is driving new infection in the north-eastern states. Drug injectors account for 1.7% of India’s HIV infections up from 0.9 % two years ago. With Punjab and western Uttar Pradesh emerging as the new epicentres of injecting drugs these numbers are expected to rise in India. The injecting drug use accounts for approx one in three new HIV cases outside sub-Saharan Africa.

According to UNAIDS 2009 report, in Eastern Europe and Central Asia HIV prevalence can be as high as 70% among people who inject drugs. The rise in infections has prompted public health experts to ask governments to decriminalise drug users and lift bans on drugs such as methadone and buprenorphine which are used for substitution maintenance therapy at de-addiction centres.

Drug addicts are reluctant to register at de-addiction centres for fear of harassment by the police .They are patients and not criminals. Scientific evidence has to be incorporated into illicit drug policies that are pushing injectors from prevention and care services infections.

In India adult HIV prevalence has dropped from 0.45% in 2002 to 0.29% in 2008 to its lowest ever number of 2.27 million. All states except Andhra Pradesh are reporting less than 1% infection down from five states in 2002. However unprotected sex ( 87% heterosexual and 1.5% homosexual )remains the biggest route of infection in India.

While the world is focusing on using innovations in science, diagnostics and understanding the virus, India has chosen to stick to the tried and tested methods of controlling HIV.According to NACO, the main focus is on scaling up of existing prevention methods such as preventing mother-to child transmission and ensuring blood safety ,focusing on prevention efforts on the communities where transmission is the highest such as migrants, men who have sex with men, injecting drug users and sex workers.