Understanding the IDU community and their vulnerabilities

1. Understanding the IDU community and their vulnerabilities

2. Profile of a Typical IDU • The typical IDU: • Male • In his productive years, but not likely to be regularly and gainfully employed • May be married, but likely to have poor social support • Severe dysfunction in almost all aspects of his life (social, legal, financial/occupational, relationships) Contd…

3. Profile of a Typical IDU • Also likely that an IDU TI will encounter IDUs who: • Have limited resources to: • Sustain themselves • Maintain hygiene • Arrange basic nutrition • Access shelter • In conflict with the law (due to illicit drugs, crime) • Co-morbidity: physical and mental – common • Atypical IDUs who may require attention: • Women IDUs • IDUs belonging to better socio-economic strata, holding white-collar jobs and staying with their families • IDUs who are also other HRG members (FSWs, MSM, etc.)

4. Why are IDUs Vulnerable? • Illicit drug use; in threat of/conflict with law • Stigma – self & societal • Preoccupation with drugs • Lack of resources • Injecting drug use

5. Injection-related Vulnerabilities • Injecting in hidden locations; mostly unhygienic in nature • Inability to clean the injecting site properly due to: • Sense of urgency • Withdrawal symptoms • Non-availability of clean water, alcohol,swabs, etc. • Injecting in unsafe parts of body: • Such as groin, thigh or neck • Vein damage and accidental injury to arteries • Abscess • Overdose • Risk of HIV, Hepatitis B & C

6. Sharing • Injecting is very often a group activity • The sharing may involve: • Sharing needles • Sharing syringes • Sharing injecting paraphernalia (i.e. the cookers or pots in which drug has been prepared for injecting)

7. Why Do IDUs Share? • Economic reasons: Lack of money to buy needles/syringes (N/S). Injecting equipment may be available only at a pharmacy, who may be reluctant to sell N/S or may choose to sell them at a premium • Psychological reasons: They feel their bonding with each other will be strengthened by this act • Poor awareness of consequences of sharing or of safe injecting practices

8. Vulnerability due to Drug Use • IDUs at greater risk of transmission of infections through the sexual route than general population • Due to drug use judgement is compromised resulting in greater risk taking in many of their actions, including sexual acts • Drugs affect their ability to work with hands and fingers – making it difficult to wear and take off a condom correctly • Drug use often leads to disruption of relationships and broken families, leading IDUs to engage in sex with casual and/or commercial partners • IDUs may be compromised to sell sex to procure drugs. More true for female drug users adding to their vulnerability of contracting HIV, Hepatitis B infection

9. Impact on Women and Children • Burden of supporting family may fall on women and children • Women may be pushed into sex work • Financial & family issues may cause children to drop out of school • Health issues may be compromised • Vulnerable to domestic violence

10. Female IDUs and their Special Needs • Female IDUs have greater challenges than male IDUs • Drug use among females more stigmatised than males so more hidden • Women (due to social inequality in providing education, health care and employment) have little or no power status in society, or social expectations • Biological factors (like being physically less strong than men) makes women vulnerable to physical violence • Biological make-up of women puts them more at risk of HIV and STIs

11. IDUs Need Services • IDUs would require help regarding: • High-risk behaviours • Drug-related issues • Co-morbidities • Many other areas of life

12. THANK YOU