The number of syringes given out to a client daily is limited (usually two or three). Syringes are also available over the counter, but they are relatively expensive: one syringe costs about 7 rupees, the same price as enough bread to feed three people. IEC materials provided by outreach workers and peer educators that should address all treatment-related issues in relation to TB, STIs and hepatitis usually lack information on those diseases. This is partly due to the low level of literacy among the population. Overdose prevention and response services are not available in most locations, so people who inject drugs avoid calling an ambulance in case of an overdose. As a response to this, some organisations like SASO have established emergency teams who provide an immediate injection of Naloxone, if needed. Since Naloxone is a prescription drug in India, it needs to be considered in programme design. To summarise, despite the fact that India has significant experience in HIV prevention, programmes mostly focus on testing, treatment and PMTCT. Although harm reduction concepts are not new in India, harm reduction interventions are not widespread and not widely accepted. Abstinence-based approaches to drug use predominate.
The assessment team visiting SPYM (Society for the promotion of youth and masses) project in Dehli, India. Š Slava Kushakov/International HIV/AIDS Alliance in Ukraine
Recommendations Based on the findings of the assessment recommendations for Alliance India, suggested that the following components are included in the HIV and AIDS response programme in India: n
n
18
Expand outreach interventions to cover rural and remote areas, providing injecting equipment and information on HIV and AIDS and STIs to people who inject drugs in those areas. Introduce a controlled secondary syringe exchange programme to develop a better understanding of drug-using populations and increase the number of clients.
Reaching drug users with outreach services