Understanding the IDU community and their vulnerabilities

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Profile of a Typical IDUThe typical IDU:

Male In his productive years, but not likely to be

regularly and gainfully employedMay be married, but likely to have poor social

supportSevere dysfunction in almost all aspects of his

life(social, legal, financial/occupational, relationships)

2Contd…

• Also likely that an IDU TI will encounter IDUs who: Have limited resources to:

Sustain themselves Maintain hygiene Arrange basic nutrition Access shelter

In conflict with the law (due to illicit drugs, crime) Co-morbidity: physical and mental – common

Atypical IDUs who may require attention: Women IDUs IDUs belonging to better socio-economic strata,

holding white-collar jobs and staying with their families

IDUs who are also other HRG members (FSWs, MSM, etc.)

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Profile of a Typical IDU

Why are IDUs Vulnerable?Illicit drug use; in threat of/conflict with lawStigma – self & societalPreoccupation with drugsLack of resourcesInjecting drug use

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Injection-related VulnerabilitiesInjecting in hidden locations; mostly unhygienic

in nature Inability to clean the injecting site properly due

to:• Sense of urgency • Withdrawal symptoms • Non-availability of clean water, alcohol,swabs, etc.

Injecting in unsafe parts of body:• Such as groin, thigh or neck

Vein damage and accidental injury to arteries AbscessOverdose Risk of HIV, Hepatitis B & C

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SHARING Injecting is very often a group activityThe sharing may involve:

Sharing needlesSharing syringesSharing injecting paraphernalia (i.e. the

cookers or pots in which drug has been prepared for injecting)

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Why Do IDUs Share?

Economic reasons: Lack of money to buy needles/syringes (N/S). Injecting equipment may be available only at a pharmacy, who may be reluctant to sell N/S or may choose to sell them at a premium

Psychological reasons: They feel their bonding with each other will be strengthened by this act

Poor awareness of consequences of sharing or of safe injecting practices

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Vulnerability due to Drug Use IDUs at greater risk of transmission of infections through

the sexual route than general population

Due to drug use judgement is compromised resulting in greater risk taking in many of their actions, including sexual acts

Drugs affect their ability to work with hands and fingers – making it difficult to wear and take off a condom correctly

Drug use often leads to disruption of relationships and broken families, leading IDUs to engage in sex with casual and/or commercial partners

IDUs may be compromised to sell sex to procure drugs. More true for female drug users adding to their vulnerability of contracting HIV, Hepatitis B infection

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Impact on Women and ChildrenBurden of supporting family may fall on

women and childrenWomen may be pushed into sex work Financial & family issues may cause

children to drop out of schoolHealth issues may be compromisedVulnerable to domestic violence

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Female IDUs and their Special Needs

Female IDUs have greater challenges than male IDUs

Drug use among females more stigmatised than males so more hidden

Women (due to social inequality in providing education, health care and employment) have little or no power status in society, or social expectations

Biological factors (like being physically less strong than men) makes women vulnerable to physical violence

Biological make-up of women puts them more at risk of HIV and STIs10

IDUs Need Services IDUs would require help regarding:

High-risk behaviours Drug-related issues Co-morbidities Many other areas of life

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