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TI for IDUs

TI for IDUs. Routes of HIV Transmission. IDU. Blood. 1.9. Sexual. 1.8. Perinatal. 84.6. 4.3. 5.6. Unidentified.

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TI for IDUs

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  1. TI for IDUs

  2. Routes of HIV Transmission IDU Blood 1.9 Sexual 1.8 Perinatal 84.6 4.3 5.6 Unidentified HIV infection in India is mostly through sexual route. Just 2 out of 100 HIV positive people are IDU. Why bother with IDU programmes when the ratio is less compared to sexual route? SENTINEL SURVEILLANCE 2006

  3. HIV Prevalence – Various Groups 7 out of 100 IDUs are infected with HIV. This is the average for the country. However, high rate of HIV (>5%) among IDU in many sites/ cities (SS 2006) ensures a high chance of spread of HIV from IDU to IDU as well as the general community

  4. IDU & HIV Wives and girlfriends of Wives and Substance users girlfriends of Clients clients of FSWs Female Sex Workers IDU IDUs HIV Husbands and boyfriends of FSWs RISK RINGS Substance Users HIV among IDUs can spread to general population through sexual partners/routes. Hence, the need for intervention among IDUs.

  5. IDU Intervention in NACP III • Estimates: 190,000 IDU in the country • Objective: prevent transmission of HIV • Approach: harm reduction (incorporated in the National Policy) • Service delivery • Targeted Intervention • Delivery by NGOs • Provision of services at doorstep of IDU • Service recipients: IDU and sexual partners

  6. Harm Reduction Services • There would be 3 tiers of harm reduction services offered to IDU through TI. Tier 1 & 2 would be offered directly; 3rd would be provided through linkage/referral: Direct service delivery Linkage services Tier 1 Tier 2 Tier 3 Opioid Linkages Substitution Outreach Therapy Services Activity (OST)

  7. Tier 1: Outreach Activity • Delivered through ORW and PE • Services • Needle Syringe Exchange Programmes (NSEP) • Condoms - free distribution and social marketing • Primary health care, STI and abscess management • Behaviour Change Communication (BCC)

  8. Tier 2: Opioid Substitution Treatment • Delivery by NACO accredited agencies • Substitution agents: Buprenorphine, Methadone • Initiated by a trained physician and administration through trained personnel • Psychosocial services • Follow-up by ORW/PE • Provision/link to Tier 1 Services • Strict record maintenance

  9. Tier 3: Linkage Services • Linkages • ICTC (voluntary informed consent) • ART, DOTS, RCH • Waste management agencies • Accompanied referrals by ORW/ PE • Established referral networks with medical, legal and welfare schemes • Linkage with detoxification and rehabilitation centres

  10. Enabling Environment ‘To create a milieu where IDU are able to access services freely without interference’ • Advocacy with law enforcement agencies • Regular advocacy with community leaders • Periodic advocacy with health workers • Raising public awareness including Advocacy for General Population

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