Indian journal of psychiatry · 2026
Evaluation of comprehensive targeted intervention (TI) services among persons who inject drugs (PWIDs) in Himachal Pradesh.
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Kumar Dinesh, Raina Sunil
Аннотация
BACKGROUND: This study emphasized the necessity of evaluating both covered and non-covered People Who Inject Drugs (PWIDs) to identify implementation issues and enhance service delivery. The objective was to assess the availability and accessibility of Targeted Intervention (TI) services and factors influencing their implementation.
METHODS: A mixed-methods study was conducted from September 2024 through March 2025, utilizing a cross-sectional survey (of both TI and non-TI PWID) alongside focus group discussions (FGDs).
RESULTS: Quantitative data were collected from 646 PWID (TI: 454; non-TI: 192), complemented by 10 FGDs. The participants' mean age was 28 years, with a mean age of initiation for substance use at 22 years. PWID enrolled in TIs were significantly more likely to reside in their home districts, inhabit urban areas, and be engaged in small-scale business. Although TI-enrolled participants showed higher rates of human immunodeficiency virus (HIV) awareness, testing, and access to sterile needles/syringes, overall coverage remained low for Opioid Substitution Therapy (OST), routine screenings for sexually transmitted infections/reproductive tract infections (STIs/RTIs), and consistent condom use. Narrative analysis revealed general satisfaction with existing services but highlighted a critical demand for localized OST, expanded needle/syringe access, and vocational rehabilitation.
CONCLUSIONS: Coverage of TI services was better for HIV testing and fresh needles/syringes. TI services need to be strengthened and expand their coverage for OST, improving local access to needles/syringes, and sexual health services (RTIs/STDs and condom programming). TI program should also devise a mechanism to engage non-TI PWIDs to provide services.
METHODS: A mixed-methods study was conducted from September 2024 through March 2025, utilizing a cross-sectional survey (of both TI and non-TI PWID) alongside focus group discussions (FGDs).
RESULTS: Quantitative data were collected from 646 PWID (TI: 454; non-TI: 192), complemented by 10 FGDs. The participants' mean age was 28 years, with a mean age of initiation for substance use at 22 years. PWID enrolled in TIs were significantly more likely to reside in their home districts, inhabit urban areas, and be engaged in small-scale business. Although TI-enrolled participants showed higher rates of human immunodeficiency virus (HIV) awareness, testing, and access to sterile needles/syringes, overall coverage remained low for Opioid Substitution Therapy (OST), routine screenings for sexually transmitted infections/reproductive tract infections (STIs/RTIs), and consistent condom use. Narrative analysis revealed general satisfaction with existing services but highlighted a critical demand for localized OST, expanded needle/syringe access, and vocational rehabilitation.
CONCLUSIONS: Coverage of TI services was better for HIV testing and fresh needles/syringes. TI services need to be strengthened and expand their coverage for OST, improving local access to needles/syringes, and sexual health services (RTIs/STDs and condom programming). TI program should also devise a mechanism to engage non-TI PWIDs to provide services.