Injecting drug users (IDUs) were recruited from the streets of Calcutta to obtain a baseline biological and behavioural data on risk practices. One-fifth of them (mostly using buprenorphine) tested positive for hepatitis B surface antigen (HBsAg); 4% were reactive to serologic test for syphilis (VDRL: Venereal Disease Research Laboratory). Condom use was insignificant while 74% reported sex with female sex workers and 15% of male IDUs also reported having sex with men. Although, sharing of injecting equipment ('works') was perceived as dangerous by the IDUs, majority of them (90/103) reportedly shared it; cleaning of works before sharing was a concern for intravenous but not for intramuscular drug injecting. Half of the IDUs reported suffering ever from abscess; a proportion (12%) of which had had superadded attack of maggots in it. They were also found to be infected with HIV (1%, 95% CI 0.028-5.97%) at a low prevalence that prompted subsequent launching of needle syringe exchange programme, establishment of cleaning norms before sharing of works, cleaning of injecting site on the body and condom promotion.
PIP: To obtain baseline biologic and behavioral data on HIV risk practices among injecting drug users in India, 126 current drug users were recruited from the streets of Calcutta in 1996. 103 study participants (82%) reported injecting drugs in the preceding 6 months. Among current injectors, the median duration of drug use was 13 years and that of injecting drug use was 5 years. 90 current injectors (88%) had shared injection equipment at last use, most often with 3 other men. Although 89 (86%) of current injecting drug users perceived the sharing of syringe and needle works as dangerous, only 11% cited the danger of HIV infection. 74% reported sex with commercial sex workers and 15% had engaged in homosexual encounters; condom use was negligible, however. Serologic testing revealed a 1% prevalence of HIV, a 4% reactivity to a test for syphilis, and a 19% rate of hepatitis B. Abscess, present in 52 drug users (51%), could serve as a marker of morbidity among injecting drug users in Calcutta. Recommended, to reduce the risk of HIV transmission in this population, are a needle-syringe exchange program and interventions highlighting safer sex practices.