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Stages of Behavioral Change and Associated Factors Among Female Injecting Drug Users in Imphal, Manipur, India: An
Lamabam H Singh1, Nandu Krishna1, Jayita Pal1
1Epidemiology and Public Health, All India Institute of Hygiene and Public Health, Kolkata, IND.
Cureus
|April 13, 2026
Summary
Female injecting drug users in Manipur show motivation for change but struggle with recognizing substance use problems. Interventions must be gender-sensitive and provide stage-matched support to address ambivalence and dependence.
Area of Science:
- Public Health
- Addiction Medicine
- Gender Studies
Background:
- Female injecting drug users (FIDUs) in Manipur face significant stigma and health risks despite harm-reduction access.
- Assessing readiness for change is crucial for developing effective, gender-responsive interventions for FIDUs.
Purpose of the Study:
- To assess the readiness for change among female injecting drug users in Manipur.
- To identify factors influencing readiness for change and inform gender-sensitive interventions.
Main Methods:
- An explanatory sequential mixed-methods design combining quantitative (SOCRATES-8D scale, n=125) and qualitative (in-depth interviews) data.
- Quantitative analysis involved descriptive and inferential statistics, while qualitative data underwent thematic analysis.
Main Results:
- Over half of FIDUs were also female sex workers; peer pressure was a common initiation reason.
- A majority (71.2%) showed low recognition of substance use as a problem, with high ambivalence (73.6%).
- Older age, marriage, earlier initiation, and less frequent injecting were associated with higher "Taking Steps" scores.
Conclusions:
- FIDUs demonstrate motivation but low problem recognition and unstable change efforts due to ambivalence, dependence, and structural barriers.
- Stage-matched, gender-sensitive counseling and enhanced early support are vital within harm-reduction services for sustained change.
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