Clinicosocial profile of people who inject drugs receiving opioid substitution therapy at New Delhi

Abstract

Introduction: Injecting drug use is a public health concern due to its clinical, social, economic, and legal consequences. Objective: (1) To evaluate the prevalence of infections associated with injecting drug use; and (2) To assess the social profile of substance users and high-risk behaviors among people who inject drugs (PWID) receiving opioid substitution therapy (OST). Materials and Methods: A cross-sectional study was conducted among 100 PWID who were deemed eligible using inclusion and exclusion criteria. Data were collected through an interviewer-administered structured questionnaire after obtaining informed written consent. Results: The results revealed that 14% of PWID had human immunodeficiency virus (HIV), 7% had tuberculosis, and 2% had hepatitis B virus (HBV). None of the PWID self-reported hepatitis C virus (HCV) infection. Importantly, 71% of PWID were living on the streets (i.e. homeless), and 41% of PWID had a history of sharing needles with other users in the preceding 3 months. Unmarried or single PWID had significantly increased risk of homelessness (χ2 = 4.570; P = 0.032) and reported high-risk sexual practices with commercial sexual partners in the preceding 3 months (χ2 = 4.163; P = 0.041). Homeless PWID had significantly increased frequency of injecting practices (P = 0.020). Conclusion: Despite the higher global prevalence of HCV compared with HBV and HIV among PWID, HCV testing is not currently conducted at most OST centers in India. Access to free needles and syringes should be enhanced to reduce the morbidity associated with injecting drug use.

Keywords

• forensic psychiatry
• hepatitis
• human immunodeficiency virus
• opioid substitution therapy
• people who inject drugs
• risk of infection
• substance use