Project Targeted Intervention for high risk group – IDU’s partnered with DSAC – Delhi State Aids Control Society.

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We were allotted a targeted intervention programme by DSAC (Delhi Society for AIDS control, Govt. of India), for to work on prevention of HIV in the areas of West Delhi. The core high risk group that IEWS intends to work with is injecting drug users. We were given areas of Delhi to perform Needs Assessment, interview IDUs, establish a health and recreation centre and offer awareness of AIDS to the target group.
 
Knowledge, Opinion And Attitude Towards STI /HIV/AIDS

During our survey we found that mostly people do not know anything about STI/HIV/AIDS, means that they are totally unaware of it, few of them have heard about it but there is no proper knowledge. Most of them told us that it spreads through sex only but they didn’t know how it spreads actually and what are other the factors. Some knew that it spreads through un-sterile syringe and needles, through transmission of HIV +ve blood during blood transfusion, but didn’t know how it spreads from HIV infected mother to child.

Attitude about STI/HIV/AIDS

They don’t want to listen about anything regarding STI/HIV/AIDS.
• They have left their homes & do not want to go back.
• They don’t want to live without drugs.
• They don’t fear death and think that this is the best life.
• Society doesn’t want to accept them and they don’t want to accept the norms of society.
• Very few want to leave this addiction but are not aware of the way out.

Marriage And Live in Partners
According to our study, the number of married population are very few in comparison to unmarried population. Our team studied that unmarried population were having live-in relationships with other partners like male with male, male with female, female with female .The maximum ratio we found, was male with male. Mostly IDUs are unmarried, they want to live with their own friends-circle. Many of them left homes & their families (wife & children).

Sexual History - No of Partners

Their sexual activities are limited to their co-wrorkers, commercial sex workers, and with those who are living with their co-workers. The history of sexual behavior of the target group is that they gave us a very mixed response, some had sexual relationship but did not want to disclose, some of them are sexually very active & have many partners, and do not miss a chance whenever they get it. But mostly IDU’ s have two or three partners, and these are women who work as rag pickers.

Sexual History – Regular Partners

When we talked to the Target Group regarding regular partners, most of them refused outrageously. They are very apprehensive about this issue. Most of them were not aware of Condom and its use and had a very casual approach to condom knowledge or to learn about the same.

Sexual History – Commercial Partners

Most of the IDUs were not cooperative with our team. The team also faced problems from the community as they were not forthcoming on this issue. While we interviewed the IDUs, many times the police came to check with the result of a disruption and sudden escape of the IDUs from the spot. They also stopped talking to our team, when they saw a person from the community approaching nearby Sexual History – Non-Regular & Non-Paying Sexual Partner During the interview the target group shared with our team that they have a frequency of approaching non-regular partners atleast 2-3 times in a month for sex. Most of them do not practice the use of condoms or understand its benefit. They also shared that they never miss a chance of having sex with women like rag pickers, street women, and trans-genders.

Risk Perception & Exposure to Intervention

Most of the target group gave no response because of lack of knowledge. Those that answered gave vague replies showing that they too lacked awareness on this issue. Only 23% of IDUs were found to know about the use of condom and its benefits.

According to the survey done by our team, it was disheartening to know that IDUs and even non-target population had no knowledge about HIV. Only 1% answered in affirmative when asked about HIV. Receiving medical treatment was quite out of question as they lacked the basic knowledge about STI/HIV/AIDS.

ACCESSIBILITY & AVAILABILITY OF SERVICES & PRODUCTS

Incidence of Violence by Police , Goons & Others
One day when we reached Shyam Nagar park (Hot Spot), we found very few IDUs at the spot. Upon inquiry we came to learn that the day before, there was a theft reported in the same area and Police had caught an IDU for the crime. The IDUs upon learning this incident escaped from the site to avoid harassment by the Police.

Note:
We found by interacting with both community and IDUs that the community always blamed the IDUs without any reason. Because of this the IDUs faced harassment from all parts of society.

Accessing Services IDU Products


IDU’s products are
1. Phenargen injection
2. Zocin injection
3. Activa injection
4. Geroillim injection
5. Kavil injection (Combination with Avil)
6. Avil injection
7. Diazepam injection (Combination with Avil)
8. Norfin injection
9. Netropine injection
10. Atnock tablets injection
11. Needle and syringes
12. Smack

All the Above mentioned products are easily available and can be purchased from any chemist shop, and also from merchant & RMP Doctors, drug peddlers, local provision store illegally.

 
PROPOSED STRATEGIES TO INITIATE TARGETED INTERVENTION
(on the basis of NA Study Finding)
 
Our Strategies are as mentioned below

1. Networking with other NGOs /CBOs (Community Based Organization )
2. Awareness Program (prevention)
3. NSEP(Needle and Syringe Exchange Program)
4. Abscess management
5. BCC (Behavior Change and Communication)
6. OST (Oral Substitute Therapy) program.
7. Conducting FGD (Focus Group Discussion)
8. Conducting Stake holder interview
9. Conducting Health campaign to address remedial & medical issues
10. Community awareness & sensitization programme for people to understand the problems of Target Group and get involved in a positive manner to support our initiatives
 
Picture of a park where IDUs come & take drugs. Our out Reach Workers are sitting with them after conducting Focus Group Discussion IDUs take ‘pleasure’ in consuming drugs
 
 
 
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