project: injecting drug users by Mehak and Vidhi

This programe was evaluated by students of Department of Public Administration, Panjab University, Chandigarh.
IDU is an NACO programe that is aimed to reduce HIV AID spread by drug injecting user

1. Project on Injecting Drug users Member in Charge Dr. DK Verma Presented by : Mehak Sharma Vidhi Simer Program Director Ms. Saroj Bala

2. The Injecting Drug Users (IDU) program is under the National AIDS Control Organization (NACO) are designed to address the high risk of HIV transmission among people who inject drugs. Here are the key components and objectives of these program:   1. Harm Reduction Approach: - The program focuses on reducing the negative health, social, and legal impacts associated with drug use rather than solely aiming for abstinence.   2. Needle and Syringe Exchange Programs (NSEP): - Clean needles and syringes are distributed to prevent the transmission of HIV and other blood-borne infections through shared injecting equipment. About IDU Program

3.   3. Oral Substitution Therapy (OST): - Provides substitution drugs (e.g., methadone, buprenorphine) to reduce dependence on injected drugs and thereby lower the risk of HIV transmission. 4. Peer Education and Outreach: - Former or current drug users are trained as peer educators to disseminate information about safe injecting practices, HIV prevention, and available health services.     The OST

4. 5. HIV Testing and Counselling: - Offering voluntary HIV testing and counselling services to facilitate early detection and linkage to treatment and care 6. Community Engagement: - Involving communities in supporting harm reduction programs and reducing stigma and discrimination against drug users.   7. Behavioural Change Communication: - Conducting awareness campaigns and educational activities to promote safer behaviours and reduce risky practices among IDUs.  

5. 8. Collaboration with NGOs and CBOs: - Partnering with non-governmental and community-based organizations to implement targeted interventions and extend the reach of the program.   9. Monitoring and Evaluation: - Regular assessment of program effectiveness to ensure the interventions are achieving the desired outcomes and making necessary adjustments for improvement.   NACO’s IDU programs aim to reduce HIV prevalence among injecting drug users, improve their health outcomes, and integrate them into broader public health and HIV prevention strategies.

6.   In Chandigarh , SOSVA as a field Ngo, operates this program as per the guidelines of NACO and Chandigarh State AIDS control Society (CSACS) is funding agency of this program.

7. What is HIV/AIDS Introduction: HIV/AIDS: Human immunodeficiency/ Acquired immunodeficiency syndrome Virus Chronic, potentially life-threatening condition caused by HIV, weakening the immune system. Impact: Over 36 million deaths worldwide since its discovery. Major Reasons for the Spread of HIV/AIDS: 1. Unprotected Sexual Contact: - Most common mode of transmission. 2. Sharing Needles : - Contaminated needles/syringes for drug injection transmit the virus.

8. 3. Mother-to-Child Transmission: - Passed during pregnancy, childbirth, or breastfeeding. 4. Blood Transfusions: - Receiving contaminated blood/products (less common due to screening). 5 . Lack of Awareness and Education: - Insufficient knowledge about prevention and transmission. 6. Stigma and Discrimination: - Fear of stigma prevents testing, treatment, and disclosure.

9. . Why people do drugs? Here are some key points on why people might use drugs: - Coping Mechanism: To manage stress, trauma, or mental health issues. - Pleasure and Euphoria : Seeking the pleasurable effects or high that drugs can provide. - Peer Pressure : Influence from friends or social circles encouraging drug use. - Curiosity: A desire to experiment and experience new sensations. - Boredom: Using drugs as a way to pass time or escape from monotony. - Socioeconomic Factors: Poverty, lack of education, and unstable income can contribute to drug use. - Accessibility: Easy access to drugs increases the likelihood of use. - Family History: Genetic predisposition and family environment can play a role. - Escapism: To escape from reality or difficult life situations. - Self-medication : Using drugs to alleviate physical pain or emotional distress.

10. THE PROJECT OF IDU   Working place: - IDU Centre at Dadu Majra, Sector 38, Chandigarh. - Since April 2015, Chandigarh State AIDS Control Society has sponsored a project for injecting drug users (IDUs). - Annual grants are sanctioned to offer services to IDUs by CSACS.

11. There are 2 IDU centres: 1. Sector 38, Chandigarh: Oral Substitution Therapy & Centre for Targeted Intervention 2. Sector 56, Chandigarh: Oral Substitution Therapy

12. Observations and Findings - IDUs collect syringes and contraceptives; former IDUs on OST visit regularly for medication. Bio-waste section for disposing of medical waste is managed by municipal authorities.

13. Dedicated workspace for the doctor, ANM, counsellor, and project manager. Doctor and ANM provide free medical care and monitor health for OST dosage. ORWs educate high-risk group (HRG) drug users on safe practices and provide medical services 99.1% of the active OST clients are Males while the percentage of active female OST clients are only 0.8%.

14. Accountant manages data records, updates, and links TI numbers with Aadhar Cards. Master sheet Form A Form B Form C Reasons for drug use include stress, trauma, peer pressure, curiosity, and environmental factors Many IDUs come from poorer backgrounds; most satisfied with services, some request more medication.

15. Among HRGs, 92 individuals; each ORW targets IDUs tested before receiving medication. Many IDUs come from poorer backgrounds; most satisfied with services, some request more medication. IDU registration requires being at least 18 years and having injected in the last 90 days. Female ORW, Ms. Honey, works with spouses of HRGs. HIV-positive individuals receive ART treatment at designated medical institutes; IDU center tracks treatment.

16. The ANM registers the dosage given to IDUs, there were two types of OSTs in the centre depending upon the requirement set by doctor and IDUs needs given by ANM. In the year 2023-2024, two new HIV/AIDS patients were diagnosed, indicating a recent increase in cases. Since the inception of the program, a total of 22 patients have been identified, with two cases detected in the last year. In the year 2023-2024, 48 beneficiaries were registered for Oral Substitution Therapy (OST), reflecting a significant enrollment milestone and highlighting the program's success.

17. Impact and Assessment Effective in reducing HIV transmission among IDUs through needle exchange programs and oral substitution therapy. Aims to mitigate HIV/AIDS incidence and curtail drug usage among beneficiaries.

18. Participants show improved health outcomes, better HIV/AIDS management, reduced infections, and increased healthcare access. Promotes safer injecting practices, minimizing the risk of blood-borne infections. Facilitates community integration, reduces stigma, supports rehabilitation, and social reintegration.

19. Peer educators spread knowledge, provide support, and promote healthier choices among drug users. Enhances access to HIV testing, counseling, treatment, and essential healthcare. Supports broader public health goals of disease prevention and health promotion

20. Success Story The story of Aniket. The story of Harwinder

21. Challenges Staff Feedback: Challenges faced by IDU, Dadu Majra: Individuals transitioning from injection drug use to Oral Substitution Therapy (OST) often revert to their former routines, resuming drug use and leaving the course midway. Issues with OST timings: :Winter hours are 9 am – 12 pm; Summer hours are 8 am – 12 pm. Timings of OST are often not well suited to the working beneficiaries as the general working hours are 9 am to 5 pm.

22. Operational Challenges : OST users sometimes misbehave with ANM, demanding more medication than prescribed and threatening staff. Lack of effective record management and reporting to SOSVA. Delays in salary and lack of incentives negatively affect employee efficiency. Lack of motivational drive in the staff.

23. Suggestions for Improvement Enhanced Security: Provide security at the center to prevent conflicts between beneficiaries and staff. Youth Inclusion: Include children under 18 who are using drugs to prevent early addiction and consequently preventing HIV transmission. Targeted Intervention : Expand the program to include underage/minor IDUs.

24. Public Awareness: Incorporate seminars and workshops to educate the public on the program's importance. Male Nurse for OST: Hire a male nurse to handle male IDUs more effectively. Social Media Presence: Create a social media handle for the IDU program to raise awareness and improve connectivity.

25. Monitoring Mechanisms : Establish rigorous monitoring to assess effectiveness, identify areas for improvement, and ensure accountability. Boosting employee morale : By introducing certain incentives or appreciation in order to fulfill esteem needs of employees; either in the center or through social media posts. Leadership Improvement: Improving leadership techniques can greatly help efficient human resource management and hence effective working.

26. Our internship at SOSVA, with our focus on the HIV/AIDS prevention program including targeted intervention and opioid substitution therapy, provided valuable insights into the program's operation and impact. We observed significant efforts to reduce HIV transmission among injecting drug users. Despite facing challenges like retention in OST and security issues, the program has achieved notable success in improving health outcomes, promoting safer practices, and reducing stigma.

27. Our recommendations for flexible OST timings, enhanced security, increased manpower, and comprehensive public awareness initiatives aim to further strengthen the program's effectiveness .

28. Thankyou We are open for any questions and suggestions .