Risk-taking profile of injection drug users in Chennai, India

Background: Few studies have described the injection and risk-taking practices of injection drug users (IDUs) in India in a systematic fashion. This paper provides a detailed descriptive analysis of demographics, injection practices and risk behaviours of IDUs in Chennai, the capital of Tamil Nadu State in southern India. Methods: This paper presents descriptive baseline data from 912 IDUs in Chennai, India collected in 2006. The study was approved by the YRGCARE IRB. The Chi-squared test was used to compare demographic and other covariates between HIV positives and negatives. Results: Of the 912 IDUs recruited, 272 (30%) were HIV infected. The majority were Tamil, male and married, earning less than USD 75 per month. 80% had injected in the prior 1 month, with HIV positives injecting more frequently (p < 0.0001). 79.4% injected heroin and 61.9% shared needles. The majority injected at the dealer's house, especially HIV positives (p < 0.002), or in public spaces. Two-thirds always obtained needles from a pharmacy and 48% reported they cleaned their needles weekly, but the majority used only water. Commonest places to store needles were in syringe lockers or buried in the ground; 59% disposed of needles in the garbage. Nearly half (45%) attempted to disable a needle after use and 42% attempted to dispose of the needle so that no-one else could get stuck. About half the IDUs consumed alcohol whilst on drugs, with HIV negatives drinking more often than HIV positives. HIV negatives also report having sex more often (p< 0.001). Conclusion: These results indicate a high-prevalence of risk behaviours making one susceptible for acquisition and onward transmission of HIV/HCV/HBV. There is an urgent need to implement interventions to educate IDUs on safe-injection practices, focussing especially on needle cleaning and disposal.