1. Understanding the IDU community and their vulnerabilities 1

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) 2 Contd…

3. 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.) 3 Profile of a Typical IDU

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 4

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 5

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) 6

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 7

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 8

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 9

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 10

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

12. 12 THANK YOU