Situation of injecting drug users in Chennai

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Situation of injecting drug users in Chennai

Srinivas Varadhan

E-mail: <knsvaradhan@...>

The HIV prevalence among Injecting Drug users (IDUs) in Chennai was 33% in 2002

and the sentinel surveillance conducted by Tamilnadu State AIDS Control Society

reports the HIV prevalence among IDUs as 62.5% to 63.5%. The IDUs have very

limited access to services that are currently being provided by NGOs. Most of

the HIV testing done for IDUs is through NGOs that only refer a very small

number for testing. IDUs do not voluntarily go to the VCTCs, as they fear that

they would be discriminated by the personnel in the VCTCs, which is currently

available only in the Government Hospitals. The IDUs have reported incidence

where they have been discriminated especially by the technicians in the VCTCs as

they find it difficult to draw blood from the thromboses veins of the IDUs. This

has in-turn resulted in very few of the IDUs accessing these services that are

being provided by the VCTCs in the Government Hospitals. In one incident where

an IDU had a bleeding femoral artery was refused admission to a Government

hospital and was in turn referred to another hospital. The outcome of this

incident is that the client was left stranded outside the hospital and died on

the pavement outside the hospital.

The NGOs working among IDUs do not effectively network with the VCTCs for

referral and testing of IDUs. The current situation is that the NGOs refer

clients on an ad-hoc basis especially when some research is being done where in

the clients are referred for testing. The other trend that exists in Chennai is

that some NGOs for testing the HIV sero-status of an IDU the organization pays

the IDU in cash or by providing food after collecting the blood samples for

research purpose. The client is denied follow-up services from the NGOs. In

Chennai, three NGOs work among IDUs and their services are restricted to the

geographical area that they work in.

The rehabilitation and detoxification centers do not cater exclusively for IDUs.

The services that are available are either too costly or not very effective

centers. The Government Detoxification centers are very few in number and the

service provided by these centers are very poor. In the Government

detoxification centers the admission procedure is very cumbersome e.g. If an

IDU/Drug user wants to get admitted they have to get a letter from the local

Police Station and produce it at the time of admission. NGOs and a few

recovering drug users are working to do away with this recent practice that is

being followed by the Government detoxification center. The IDUs who are

admitted in the government hospital that provides a 21-day programmed are

admitted to the wards along with mentally ill individuals. This has lead to a

decrease in IDUs availing these services. Most of the treatment centers are

not able to handle drug users during the withdrawal period and so they deny

admission to drug users.

The prevailing situation is that IDUs are being discriminated by the Government

health service providers and the services of the NGOs are not addressing the

needs of the IDUs.

The follow-up services provided by the Government hospitals are non-existent.

The follow-up services provided by NGOs are not effective as they stop with only

testing and they do not provided follow-up services if an IDU tests positive for

HIV. There is very little done in terms of care and support for IDUs and the

NGOs that provide care and support are hesitant to provide these services for

IDUs.

The number of Government VCTCs in Chennai –5-6

The number of Corporation VCTCs in Chennai – Approx. 10

The number of Community based VCTCs in Chennai – 4 to 6

The current need of the IDU population is care and support of the HIV positive

IDUs and rehabilitation centers that address the needs of the IDUs. No ART is

being provided for IDUs and the IDUs cannot afford to purchase these drugs even

though the State AIDS Control Society is providing them at a subsidized rate.

In Chennai, no IDU has so far started using ART though the HIV prevalence is

about 62.5 to 63.5% among the IDUs.

I would like to invite the attention of the state govt, central govt, ngo's,

Tnscas and capacs to take the needful steps to help the drug users.