INJECTION-DRUG USE IN CALCUTTA - A POTENTIAL FOCUS FOR AN EXPLOSIVE HIV EPIDEMIC

Our objective was to assess HIV risk perceptions, risk behaviours and factors that may facilitate an increase in injection drug use in Calcu tta. Focus group discussions and in-depth interviews were conducted wi th a selected group of drug users to delineate drug use patterns, lang uages used to express addictive and related experiences and acceptance of harm minimization messages. Results from these were used to develo p a semi-structured interview instrument which was used to interview 1 11 drug users (76 IDUs and 35 non-IDUs) recruited from jails and detox ification centres. Secondary data of narcotic seizures for the last 5 years were collected from the Calcutta police department. Data on perc entage of IDUs admitted to large deter facility in the city was also c ollected. Findings show that HIV/AIDS knowledge and risk perceptions w ere low; sharing of injection equipment was reported by 66% of the inj ectors; and condom use was insignificant. Non-availability, rising cos t and increasing tolerance to heroin were cited as factors contributin g to switch to injection. Ecological association was found between int ensified police activity and an increase in: the amount of smokable he roin seized; increased injection of buprenorphine; and admission to de toxification centres. In addition to HIV, IDUs were also found to be p rone to hepatitis B and C. The findings suggest an urgent need for dev eloping and implementing community-based HIV prevention interventions targeting drug users in Calcutta.