Study on IDU situation in Punjab and Haryana

[Guest guest]

Carrying HIV in their veins: Survey reveals alarming facts in Punjab

Aditi Tandon

Tribune News Service. Chandigarh, November 25

At 20, village boy Gurpreet can’t sleep unless he has had three rounds of drug

intake.

Starting on dope as a seven-year-old, he soon graduated to lethal levels. Now,

smoking or chewing does not yield him any pleasure. He gets his kick only out of

injecting morphine and sedatives, available easily. And he does so many times in

the day, so much so that he has exhausted most veins of his body and has only

one option left - injecting between thighs.

Gurpreet and those like him are posing to Punjab health authorities a mighty

challenge. Though related to the state’s old problem of drug abuse, this one is

clearly much more serious. Reason: It comes with the risk of HIV, known to be

transmitted through infected needles. In Punjab, as elsewhere in India, the most

recent shift in drug use patterns has been the shift from smoking or chasing to

“injecting drug use” (IDU); the shift brings with it a potential risk of HIV.

Major findings

HIV along highways: IDUs close to GT road have higher HIV positivity than those

away from it

Most users 20 to 29-year-old

HIV positivity highest among those above 44

Urban IDUs outnumber rural in numbers and HIV prevalence rates

Most drug users non-migrants

The problem, earlier known to affect northeastern states, is now also engulfing

Punjab and Haryana, where a recent UNAIDS and the Society for Promotion of Youth

and Masses (SPYM) survey found 60 per cent of 3,300 injecting drug users in 10

cities sharing needles. A crackdown on narcotics has prompted drug users into

injecting painkillers, says Rajesh Kumar of the SPYM. Other commonly injected

drugs in India are heroin, buprenorphine and dextropropoxyphene.

And if you thought that was the end of matter, here’s how IDU is threatening

Punjab. The first community-based survey of IDUs in the state reveals an overall

HIV positivity of 13.80 per cent among Punjab’s IDUs, way above India’s per cent

positivity of 10.16.

Among injecting drug users in Punjab are not only old addicts like unskilled

agricultural labourers and truck drivers but new entrants like hotel and service

sector employees, even women. The highest HIV positivity of 33.33 per cent in

Punjab has been found among IDUs from hotel industry, followed by 25 per cent

among those from service sectors.

The problem cuts across age groups, being most pronounced among the unemployed,

uneducated and unskilled sections. It is in fact inversely proportional to the

level of education; needle sharing, non-cleaning of syringes and lack of

awareness about HIV transmission through infected needles being common among the

less-educated, as per the Punjab State AIDS Control Society (PSACS) survey.

Ninety-five per cent of HIV positive IDUs sampled by the PSACS have been found

to have educational status equal to or below class XII, highlighting the need to

reach out to the uneducated. Of the 500 injecting drug users tested, only 11

were graduates; 106 illiterates, 161 class V pass outs and 222 plus two pass

outs.

“HIV transmission through IDU needs to be prevented by opening more testing and

drug counseling centres and stressing substitution therapy,” say N.M. Sharma of

the PSACS, which has also showed how HIV infection is moving along national

highways in Punjab.

For wider surveillance, the PSACS collected blood samples of IDUs from two areas

- one along the GT Road and the other from Malwa belt away from GT Road. The

findings were shocking. IDU site, SWACH, Ludhiana, representing samples from

Fatehgarh Sahib, Ludhiana, Jalandhar, Kapurthala and Amritsar along GT road

showed HIV prevalence of 21.20 per cent in the 250 IDUs tested, placing this

site at No. 5 in India in terms of IDU-HIV prevalence.

Bathinda site representing samples of IDUs from non-GT road areas of Malwa

showed surprisingly lower HIV prevalence of 6.4 per cent. Though Malwa is

considered the hotbed of drug abuse, the survey shows that all areas are

vulnerable to HIV due to IDU. India-wide, the highest HIV prevalence of 31.6 per

cent among IDU sites has been reported from Chennai, followed by Khozikode (25);

Chandigarh is eight with 17.6 per cent HIV prevalence among IDUs.

The latest findings about Punjab are alarming considering in high-prevalence

IDU-HIV areas like Manipur, HIV transmission from injecting (also called

intravenous) drug users to their spouses has been established. One study found

45 per cent of the wives of HIV-infected IDUs to be HIV positive.

In Punjab, the problem is severe among those above 44 (mostly married), who have

reported the highest HIV positivity of 22.22 per cent among IDUs classified by

age, followed by 30 to 44-year-old with 17.04 per cent HIV positivity. Highest

numbers of IDUs are from the 20 to 29 year group.

As per National AIDS Control Organization (NACO), IDU accounts for 2.2 per cent

of HIV transmissions in India. But UNAIDS India chief Denis Broun, recently in

Chandigarh, said, “Our survey shows IDU transmission figure may be higher. If

their numbers are higher, which is possible, IDU would be a major HIV

transmission route in future. Punjab and Haryana need to devise interventions to

tackle the issue.”

http://www.tribuneindia.com/2007/20071126/punjab1.htm

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