2016 update. Abou and Nini

The National AIDS Control Organisation (NACO) invited IDUF President Abou Mere and Vice President Nini Pakhma to attend the National Technical Resource (TRG) group meeting to discuss the national harm reduction program on the 19th January, 2016 at NACO committee hall, New Delhi.

It was highlighted that the HIV prevalence amongst IDUs continues to remain high and also brought to the attention of TRG members on the increasing trend observed in some of the HIV low prevalence States.

Based on the issues deliberated upon, the key recommendations made by the members are:

  1. In order to fast-track the response towards reducing the HIV prevalence amongst IDU, members deliberated upon the need to revamp / modify the TI intervention implementation model/ structure of the existing NGO which is in practice for more than two decades. The member has recommended to form small groups to brain storm out-of-box ideas before commencing the NACP-V planning exercise.Recommended to form ‘Community Warning Groups’ who may act as a catalyst to raise issues pertaining to exploring uncovered population and emerging new types of drugs.
  2. Designing district specific and if possible client specific outreach strategy.
  3. The need to strengthen the behavioral change communication strategy at the TI level in terms of addressing the sexual behavior of the IDUs in line with the observations made on the trend of condom usage with regular partners, paid partners and casual partners.
  4. The field level implementers may also look into getting regular feedback from the HRGs on various services being provided to them which may help to have a better understanding on the Quality of Services.
  5. Members recommended that Prison intervention need not be restricted only to IDU pockets/ geography and suggested to consider all the 130 central prisons. Besides, the member also recommended to carefully review the existing prison manual before rolling out Prison HIV interventions.
  6. The current OST training for the clinical staff may prioritize optimum dosage and the key focus to highlight OST with buprenorphine as one of the treatment options and not detoxification per se. The members also stressed upon the importance of creating provision for take home dosage for clients who qualify certain criteria like stabilized dosage, strong family support, health, travelling, employment, etc.
  7. The members have suggested recommending MOHFW to send circular/notification to Medical colleges for including a chapter on drug dependency / substance abuse as part of the undergraduate curriculum and NDDTC will share a concept on same MSJE shared that more than 300 de-addiction centers have been supported in the country. TRG members were of the opinion that de-addiction may be made as an additional service provision for IDUs being covered by TI-NGOs. Hence, the team suggested to have close collaboration with MJSE to refer IDUs who are in need of drug treatment facility (NACO informed that MoU between NACO and MSJE has been signed and efforts are underway for intensifying the efforts for joint action).
  8. Members recommended that India may not prefer Piloting of innovative interventions such as Low Dead Space Needles and Syringes to reduce HIV transmission among IDUs as there are no scientific evidence available globally to substantiate the results achieved.  On the other hand, members have suggested for creating provision for insulin syringes (this is already in practice in the NE region) to address IDUs who are using pharmaceutical drugs.
  9. Members have suggested NACO to collaborate with Ministry of Women and Child Welfare to address the needs of children under 18 years.
  10. Members shared that complex reporting procedure/formats restrict field staff from spending quality time with HRGs and recommended NACO to consider removing the non-critical formats.