Injecting drug users in India: Understanding sexual behaviours and sexual networks to design effective behaviour change strategies

The practice of injecting drug use has been spreading to different parts of India since the early 1980s and is associated with an increase in HIV prevalence rates. Injecting drug users (IDUs) engage in both risky injection and sexual practices that increase the risk for HIV transmission. While risky injection practices are well understood, there is limited understanding of IDUs’ sexual behaviors and social networks. The Population Council conducted a cross-sectional study to explore patterns of risky sexual behaviors, sexual network characteristics, and drivers of high-risk behaviors of IDUs in Delhi and Imphal. The contrasting settings were selected to allow for differences in social and behavioral characteristics that influence the HIV epidemic. Researchers conducted a study with current IDUs who had used nonprescription intravenous drugs in the past six months and were over 16 years of age. The study, conducted in one high- and one low-HIV-prevalence state, suggests that two different drug-use patterns are shaping the HIV epidemic. These differences, as noted in this brief, require a varied approach to addressing HIV prevention