HIV and drug use in North-East India: challenges and prospect of prevention

Ritu Kumar Mishra, Emmanuel Hospital Association

Project ORCHID (Organized Response for Comprehensive HIV Interventions in selected high-prevalence Districts of Manipur and Nagaland) was initiated in May 2004 as a collaboration between EHA (Emmanuel Hospital Association) and AIHI, now Nossal Institute for Global Health, University of Melbourne. The project received funding from Avahan, Bill and Melinda Gates Global Health Foundation. ORCHID has been working to reduce transmission of HIV and STI among Injecting Drug Users (IDUs), Female Sex Workers (FSWs), Men who have Sex with Men (MSM) and their sexual partners through a response of increased scale and coverage in selected high -prevalence districts and townships of Manipur and Nagaland in Northeast (NE) India. Orchid completed Phase 1 in March 2009 (2004-2009) and is now in Phase 2 for another 5 years. Profile: Target population: 18,000 IDUs, 4,410 FSWs, 1,100 MSM Number of districts: 13 districts (7 Manipur, 6 Nagaland) Number of Implementing partners: 31 (16 in Manipur, 15 in Nagaland) Number of Drop in Centres: 65 (30 in Manipur & 35 in Nagaland) Number of project clinics: 64 (all are within the DICs) Services provided to the Community: Clean needles and syringes and safe disposal (NSEP) Counselling and outreach services Abscess treatment STI diagnosis, counselling and treatment Free Condoms Referrals (ICTC, ART, TB) A safe space in project DICs Overdose management Key Accomplishments: Strengthened capacity of the NGOs in Manipur and Nagaland – heavy investment by the grantee (AIHI and EHA) Rapid scale-up of needle and syringe exchange program Early identification and treatment of abscesses Strong advocacy with local power structures in a very difficult terrain (geographically and in terms of insurgency) Creation of demand for ORCHID services Awarded the State Training and Resource Center (STRC) for Nagaland and Manipur to train all SACS NGOs