Open Access Research article

Spatial distribution and characteristics of injecting drug users (IDU) in five Northeastern states of India

Gajendra Kumar Medhi1*, Jagadish Mahanta1*, Rajatashuvra Adhikary2, Brogen S Akoijam3, Buno Liegise4, Kalpana Sarathy5, Chelliah Joshua Thomas6 and Bhupen Sarmah7

Author Affiliations

1 Regional Medical Research Centre, NE Region, Indian Council of Medical Research, Dibrugarh-786001, Assam, India

2 Family Health International (FHI), 16 Sunder Nagar, New Delhi 110003, India

3 Community Medicine Department, Regional Institute of medical science, Lamphelpat, Imphal- 795004, Manipur, India

4 Department of Education, Nagaland University, Kohima- 797 001, Nagaland, India

5 Department of Social Work, Mizoram University, Aizwal-796006, Mizoram, India

6 Indian Council of Social Science Research (ICSSR) North Eastern Regional Centre NEHU Campus, Shillong- 793 022, Meghalaya, India

7 Omeo Kumar Das Institute of Social Change and Development, Six Miles, Guwahati-36, Assam, India

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BMC Public Health 2011, 11:64  doi:10.1186/1471-2458-11-64

Published: 31 January 2011



Injecting drugs is the major driving force of human immunodeficiency virus (HIV) epidemic in Northeastern India. We have assessed the spatial distribution of locations where injecting drug users (IDU) congregate, as well as the risk behaviour and key characteristics of IDUs to develop new strategies strengthening intervention measures for HIV prevention in this region.


Locations of IDUs congregation for buying and injecting drugs were identified through Key Informants (KI). Verification of the location and its characteristics were confirmed through field visits. We also conducted semi-structured and structured interviews with IDUs to learn more about their injecting behaviour and other characteristics.


Altogether, 2462 IDU locations were identified in 5 states. The number of IDU locations was found to be greater in the states bordering Myanmar. Private houses, parks, abandoned buildings, pharmacies, graveyards, and isolated places were the most frequently chosen place for injecting drugs. Many injecting locations were visited by IDUs of varying ages, of which about 10-20% of locations were for females. In some locations, female IDUs were also involved in sex work. Sharing of needle and syringes was reported in all the states by large proportion of IDUs, mainly with close friends. However, even sharing with strangers was not uncommon. Needle and syringes were mainly procured from pharmacies, drug peddlers and friends. Lack of access to free sterile needles and syringes, and inconsistent supplies from intervention programs, were often given as the cause of sharing or re-use of needles and syringes by IDUs. Most of the IDUs described a negative attitude of the community towards them.


We highlight the injection of drugs as a problem in 5 Northeastern India states where this is the major driving force of an HIV epidemic. Also highlighted are the large numbers of females that are unrecognized as IDUs and the association between drug use and sex work. Understanding of risk behaviours and other key charecteristics of IDUs in the region will help in strengthening harm reduction efforts that can prevent HIV transmission.