title: Injecting and sexual risk behaviours, sexually transmitted infections and HIV prevalence in injecting drug users in three states in India.
abstract: OBJECTIVE
  To describe and compare sexual and injecting risk behaviours and sexually transmitted infections (STI), hepatitis C virus (HCV) and HIV prevalence in injecting drug users (IDU) in six districts in three states of India: Manipur, Nagaland, and Maharashtra.
  
  
  METHODS
  The respondent-driven sample consisted of 2075 IDU. Consenting participants were administered a structured questionnaire and samples of blood and urine were collected to test for HIV and STI. Data were analysed using RDSAT.
  
  
  RESULTS
  In two districts in Manipur, 77 and 98% of IDU injected heroin, whereas the main injecting drug in Nagaland was dextropropoxyphene (99%). In Mumbai/Thane, Maharashtra, the majority of respondents reported using chlorpheniramine (87%) and heroin (99%). In all districts, almost half of IDU reported generally sharing needles and syringes; consistent condom use with non-paid female partners was also low. Approximately one-quarter of IDU in Mumbai/Thane visited a paid partner in the past year. IDU with reactive syphilis serology were higher in Nagaland (7 and 19%) than in Manipur and Maharashtra. HIV in two districts of Manipur (23%, 32%) and Mumbai/Thane (16%) was greater than Nagaland (<2%). HCV prevalence was more than 50% in Mumbai/Thane and Manipur.
  
  
  CONCLUSIONS
  Irrespective of regional differences, high-risk behaviour of needle sharing and low condom use makes IDU a critical subpopulation for HIV prevention interventions. Interventions need to address the differing drug use patterns in the regions and transmission prevention among non-paid regular and casual female partners of IDU in the northeast districts and paid female partners in Mumbai/Thane.
authors.affiliation: Regional Medical Research Centre (RMRC), Dibrugarh, India. mahantaj@icmr.org.in
authors.forename: Jagadish
authors.initials: J
authors.lastname: Mahanta
authors.forename: Gajendra Kumar
authors.initials: GK
authors.lastname: Medhi
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Paranjape
authors.forename: Nandan
authors.initials: N
authors.lastname: Roy
authors.forename: Anjalee
authors.initials: A
authors.lastname: Kohli
authors.forename: Brogen S
authors.initials: BS
authors.lastname: Akoijam
authors.forename: Bernice
authors.initials: B
authors.lastname: Dzuvichu
authors.forename: Hiranya Kumar
authors.initials: HK
authors.lastname: Das
authors.forename: Prabuddhagopal
authors.initials: P
authors.lastname: Goswami
authors.forename: Gay
authors.initials: G
authors.lastname: Thongamba
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D017848:Blood-Borne Pathogens; D017280:Condoms / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult