Northeastern states report spike in HIV rate, needle-sharing driving the epidemic

Six states in India’s northeastern region account for 43.5% of injecting drug users (IDUs) who tested positive for HIV.

Close to 20% injecting drug users (IDUs) in Mizoram have HIV, compared to a nationwide prevalence of 6.26% among drug-users, shows data from National Aids Control Organisation’s (NACO) HIV Sentinel Surveillance 2017 released last month.

Six states in the region account for 43.5% of IDUs who tested positive for HIV in India. The states in the region with higher than usual national prevalence among IDUs are Mizoram (19.81%), Manipur (7.66%), and Tripura (8.55%).

Needle-sharing among IDUs is one of the reasons driving the HIV epidemic in the region, with seven northeastern states accounting for about 6% of all new HIV infections.

The health ministry began an epidemiological investigation in December last year to understand reasons why HIV prevention and treatment programmes are not working in the region.

“After the preliminary surveillance was out, we started the epidemiological investigation to know the drivers of HIV epidemic in northeast. By March, we should get an initial understanding of what is happening there,” said a health ministry official, requesting anonymity.

“The preventive programmes in place in the region have yielded positive results in other states but haven’t shown similar results in the north-east. HIV infection is going down but the last mile is always a challenge,” the official said.

Female sex workers (FSWs) and men who have sex with men (MSM) are the other groups with high HIV prevalence.

“The high prevalence among IDUs, FSWs, and MSM, as well as in ANC (antenatal clinic) populations, indicates an epidemic fuelled by multiple, possibly interrelated, risk behaviours,” reads the surveillance report.

Manipur residents claim the prevalence is likely to be higher.

“For measures to work, there needs to be adequate staff on ground, but recruitment process is long and money isn’t utilised properly,” said Deepak Leimapok Pam, president, Manipur Network of Positive People.

“The virus has spread in the general population through drug use and controlling its transmission now has become a huge challenge,” he said.

For India to meet the goal of ‘End of AIDS’ as a public threat by 2030, it is imperative to bring the numbers down. “We have reported 79,000 new infections in 2016; we need to bring it down to 20,000 by 2030,” said the official.