Rapid spread of HIV among injecting drug users in north-eastern states of India

Abstract

Manipur, a north-eastern state of India bordering Myanmar, has experienced very rapid transmission of the human immunodeficiency virus (HIV) among its vast drug-injecting population. Seroprevalence among intravenous drug users increased from 0 per cent in September 1989 to 50 per cent within six months. With a minimum injecting population of 15,000 and seropositivity of over 50 per cent, the infection quickly spread to the population at large. One per cent of antenatal mothers tested seropositive by 1991. Forming part of the area of South-East Asia known as the Golden Triangle, and producing opium and its derivatives, Myanmar shares a long international border with four States of the region, and populations with a common language and culture move freely across borders. Two other north-eastern states of India bordering Myanmar have faced a similar epidemic within a short period of time. As a result of serosurveillance for HIV since 1986, the epidemic could be detected at an early stage. The present paper provides an account of the results of ongoing comprehensive studies conducted in the north-eastern states of India on drug-related HIV infection, already a serious problem, but possibly still restricted to that region of the country. The prevalence of intravenous drug users, their HIV serological status, the demographic profile, risk behaviour, the spread of the infection to other groups and the problems of harm minimization are also covered.

PIP: The seroprevalence of HIV among IV drug users (IVDU) in Manipur increased from 0% in September 1989 to 50% six months later. In fact, reports of HIV-seropositive IVDUs are almost totally restricted to the northeastern region; less than 10 cases have so far been reported from the rest of the country. India has been categorized as a pattern III country for the spread of HIV in which the major mode of HIV transmission is heterosexual. As such, HIV seropositivity of more than 50% in a minimum injecting population of 15,000 quickly spread HIV to the general population of Manipur. 1% of antenatal mothers tested HIV-seropositive by 1991. Two other northeastern states of India bordering Myanmar have also experienced a similar epidemic within a short period of time. The authors describe results of ongoing studies conducted in these northeastern states of India on drug-related HIV infection and discuss the prevalence of IVDUs, their HIV serological status, the demographic profile, risk behavior, the spread of the virus to other groups, and harm minimization.