title: Injecting drug use in Manipur and Nagaland, Northeast India: injecting and sexual risk behaviours across age groups.
abstract: BACKGROUND
  There is an HIV epidemic among people who inject drugs (PWID) in Manipur and Nagaland, Northeast India. Approximately one-third of PWID across these two states are aged below 25 years, yet until now there has been no systematic investigation of the differences between the younger and older PWID. We sought to profile differences in drug use and sexual practices across age groups and to examine whether age is associated with injecting and sexual risk behaviours.
  
  
  METHODS
  We used combined cross-sectional survey data collected in 2009 from two surveys involving a total of 3,362 (male) PWID in eight districts of Manipur and Nagaland. All data were collected using interviewer-administered questionnaires.
  
  
  RESULTS
  Compared to PWID aged 35 years or older, PWID aged 18 to 24 years were more likely share needles/syringes in both Manipur (OR =1.8) and Nagaland (OR =1.6). Compared to PWID aged 35 years or older, PWID aged 18 to 24 years were almost two times as likely to draw up drug solution from a common container at their last injection in Manipur (OR =1.8). In Nagaland, PWID aged 18 to 24 years were more likely to use condoms consistently with both casual (OR =3.1) and paid (OR =17.7) female sexual partners compared to PWID aged 35 years or older.
  
  
  CONCLUSIONS
  Risky injecting practices were more common among younger PWID in both Manipur and Nagaland, while unprotected sex was more common among older PWID in Nagaland. There is a clear need to focus public health messages across different age groups.
authors.affiliation: Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 161 Barry Street, Carlton, VIC 3010, Australia. g.armstrong@unimelb.edu.au.
authors.forename: Gregory
authors.initials: G
authors.lastname: Armstrong
authors.forename: Amenla
authors.initials: A
authors.lastname: Nuken
authors.forename: Gajendra K
authors.initials: GK
authors.lastname: Medhi
authors.forename: Jagadish
authors.initials: J
authors.lastname: Mahanta
authors.forename: Chumben
authors.initials: C
authors.lastname: Humtsoe
authors.forename: Melody
authors.initials: M
authors.lastname: Lalmuanpuaii
authors.forename: Michelle
authors.initials: M
authors.lastname: Kermode
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult