SAKHYAM Project for IDU :

Support to IDUs TI Project in Bhubaneswar city Addressing the problems identified

Support to IDUs TI Project in Bhubaneswar city Addressing the problems identified

I

Injecting Drug Users are one of the highest risk groups with regard to vulnerability to HIV/AIDS. The risk of HIV infection for IDUs (92%) comes from sharing of injecting equipments and solutions, which may contain the infected blood. IDUs are at high risk for HIV/AIDS transmission not due to injecting drug but because of their behavior.
HIV spreads rapidly among injecting drug users because many of them share the injection equipment. A needle carrying infected blood can catapult the virus directly into the blood stream of an infected person. Sharing needle and other equipment is a highly efficient way of transmitting HIV. So the speed at which the virus moves through a drug injecting population largely depends on the equipment sharing and cleaning practices in a community. It is urgent to reduce the HIV risks associated with drug injecting risks to the users themselves, to their sex partners and children and to society. Documentation of this aspect is not very clear, so a clear picture of the pattern of this behavior does not emerge. However it is strongly indicated that there is a grave problem cutting across all the strata of society, which is possibly growing and needs urgent attention.

Achievement since Inception

      Objectives are define by the project to increase Knowledge, Skills, understanding & concern among IDUs about Sexual Health, HIV / AIDS and drugs; to provide increased access to services & promote their utilization by the IDUs for prevention & reduction of high-risk behavior; to create an enabling environment by sensitizing and mobilizing community supportive of safer behavior by the IDUs; to establish Communication and Coordination between various stakeholders.


      Project stated from 1st of June 2010 with complete staff in place. The project activities started with area mapping, some modification take place from the previous area plan after revisit the site. Finally areas are divided into 3 clusters with 10 using sites for intervention. The three clusters are divided among three peer educators. The peer educator selection process was complete with support of clean IDUs from different drug de-addiction centers and Network of Positive people members. By the end of January 2011 project identify 460 IDUs in the city. MIS develop in consultation with the team to maintain the information base of IDUs as well as monitor the program part.

      Regular field visit by PEs with formal support from Project Manager (HOPE Foundation) for understand the field situation of IDUs. During the visit they more concern about the site and spot for using drugs. The regular orientation and guidance are take place from the project for the field counsellor and PEs.

      Needle exchanges and drugs substitution program started with the target groups with support of LEPRA Society TI project Bhubaneswar. Till date FGDs/awareness are taken place in the community, to finding the problem for start up the activity. FGD was conducted with IDUs family members to create an enabling condition in the family to support them for reduce the risk of HIV.

      The IDUs highly elusive for their activities & are not well accepted by the society. The only risky aspect of their behavior is needle – sharing, which is a known route of HIV transmission. Documentation of this aspect is not very clear, so a clear picture of the pattern of this behavior does not emerge. However it is strongly indicated that there is a grave problem cutting across all the strata of society, which is possibly growing and needs urgent attention.

•     The project activities started with area mapping. Finally areas are divided into 3 clusters with 10 sites for intervention.
•     The peer educator selection process was complete with support of clean IDUs from different drug de-addiction centers and Network of Positive people members.
•     By the end of November 2010 project identify 460 IDUs in the area.
•     One to one contacted 1970 times till December 2010.
•     72 peer educator sessions completed till December 2010.
•     10 Capacity Building programmes of CBOs completed in different theme.
•     In different linkages program with TIs project of OSACS, we have provided services to 76 users are in drug substitutions and 210 person cover under needle syringe exchange program (NSEP) and 12 sites managed by the community/family members.
•     15 IDUs/PLHAs are referred to the drug de addiction center and clean for on an average of last 2 months to 9 months.
•     256 IDUs are visiting to DIC for different services i.e. counselling, SRH & HIV/AIDS, group seasons, information on abscess and vane care management.
•     102 family counselling done by field counsellor on SRH & HIV/AIDS.
•     Anti drugs day celebration with support of different agency including OSACS.
•     Involvement of the family members in social harm reduction creating a positive impact on social trust aspect among the users.
•      More involve of the ex users to strengthen the program for which Narcotic Ammoniums (NA) and Recovery Drug Users group take a lead role on follow up activity.
•     MIS develop with consultation with the team to maintain the information base of IDUs as well as monitor the program part.

Learning:

      Project learning is to understand the dynamism of the drug user to trace them for interventions. Problem faced in taking them to confidence, because by nature they are not comfortable with other community.
       Care and treatment activities like health camps (Linkages with the TIs for IDUs) are regularly conducted in the project area. It is only confined to IDUs and some extend to their family members. To address the problem the few health camps are conducted in out reach of the city. Those IDUs who attend regularly it has been seen that improving in there health conditions and also protected from Opportunistic Infections (OIs) and other allied problems. Access to treatment itself is a big challenge. In most of the area it is understood that only drug availability, in others hand it is also require for psychological support and practical assistance. Moreover it is always difficult take into account the numerous local barriers that exist for accessing drugs and treatment in order to formulate a program that is response to local needs.
      Relevance: Substance abuse continues to be a rapidly growing menace within Orissa and is compounded in recent times by the spread of HIV amongst the IDU community and the factor of high risk behavior amongst other substance abusers. IDU’s make up a significant percentage of the drug using community and currently Bhubaneswar has nearly a 40% prevalence rate of HIV infection in IDUs (informal ICTC figures).

Problems to be resolved and the needs to be met.

- Spread of HIV and STIs amongst the IDU community.
- Spread of HBV and HCV (Hepatitis B & C) amongst the IDU community.
- Abscesses and poor vein health care as a result of unsafe injecting practices.
- Incidences of overdose (OD).
- Stigma and shame associated with substance abuse which leads to unhygienic practices (shooting galleries, sharing needles etc).

To provide an entry point for IDUs into treatment and care for substance abuse reduction, HIV and STIs etc, to create awareness amongst IDUs regarding HIV, STIs, hepatitis etc, to provide a clean and hygienic space for IDUs where they will feel comfortable to visit and spend time, to establish networking and referral linkages. Result will be in a gradual reduction in HIV prevalence amongst the IDU community and better referrals to various services available in the city and State.





We require your help.

Hope Foundation’s causes are humanity’s own.