In the Northeast, former drug users are promoting the ‘harm reduction approach’ to drug abuse. Talk to a recovering user like Maoba, of Kiphire, a hill town in Nagaland, and he will tell you that the ‘harm reduction’ is just what is needed. For someone who has injected drugs for over six years and has been away from drugs for about a year, he should know.

People like Maoba now work as peer educators with a local NGO working on harm reduction. The idea is not just to give needles, but counsel, provide information, and alert users to the risk to HIV. The ‘harm reduction’ approach is aimed at preventing the spread of HIV/AIDS among the drug-using population. Since HIV can spread within and from drug users because of unsafe injections and unsafe sex, this approach combines making clean needles available to injecting users at all times, counselling them, promoting condom use and treatment of sexually transmitted diseases, and encouraging people to switch from injecting drugs to using them orally.

In Manipur and Nagaland, where the epidemic is driven by injecting drug use, awareness among users about risk to HIV and other blood-borne diseases such as Hepatitis B and C, is high. Drug users say that with safe needles now available, sharing has dropped. In Kiphire, a small hill town in Nagaland bordering Myanmar, we asked drug users and recovered users — most of them young men in the 18-30 age group — if they were aware of their HIV status. They said they would rather not know. Fear in the community is high; messages about not sharing needles and about protected sex is clearly getting across. According to NACO, HIV prevalence among injecting drug users in Manipur fell from 39 per cent to 24 per cent in the last three years; in Nagaland it has almost halved during the same time — from 9.5 per cent to 4.5 per cent.

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