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The harm reduction shift: A review of India's NACP strategies for PWID
Kapil Prajapat1, Fathima Hassan1, Lulu Sirin Chamayi2
1Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Abstract:
India's HIV epidemic is highly concentrated among People Who Inject Drugs (PWID) and who exhibits the highest prevalence among key populations despite decades of intervention. The Review highlights a policy shift from awareness-based campaigns in NACP-I to Targeted Interventions in NACP-II, the three-tier harm-reduction model including Opioid Substitution Therapy (OST) under NACP-III and differentiated care approaches, such as satellite centres and prison interventions, in NACP-IV and V. By 2023-24, programme expansion achieved 90% intervention coverage, 91.3% reported use of sterile injecting equipment and OST enrolment of over 54,000 individuals. However, HIV prevalence among PWIDs rose from 6.26% in 2016 to 9.03% in 2021. This shows indicating that service expansion has not fully translated into epidemic control.
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