Substance Abuse and HIV Risks in Kalanki and Balkhu

Background: A research was carried out in Kalanki and Balkhu areas of Kathmandu, Nepal with the objectives: (1) To assess the scope and characteristics of drug abuse among the populations of Kalanki and Balkhu; (2) To examine the sex differences in communicable diseases; (3) To find out, whether needle sharing is associated with HIV positive among the IDUs; and (4) To examine the risk taking or violent behaviour of the abusers.

Methods: A study was carried out in Kalanki from June to August 2010 where IDUs (n=250) aged 15-25 were administered a structured questionnaire. Another study was done in Balkhu area in January 2010 where 220 persons (aged 13-27) were interviewed. The Street Intercept and descriptive statistics and analysis methods were applied. Data were collected on the types of substance use, HIV infection rate, condom use, sexual behaviour, risk taking behaviour, demographic, depression and willingness to quit substance abuse. Chi-square tests and logical regression were used to find out correlation between the above issues and needle sharing within the last one year.   

Results: 90 per cent were male and only 10 per cent were female among the 250 participants in Kalanki. Median age was 20 years. Among the 65 per cent heroin injectors 35 per cent share needles. Prior to base line of 2 months, 30 per cent had >2 sex partners, 5 per cent of them had casual sex partners. However, only 10 per cent of them use condom. The research showed high prevalence of unsafe sex, injection and taking drugs before sex. 25 persons of the 250 IDUs admitted that they are HIV positive (20 male and 5 female) which showed significant gender differences. 80 per cent of the 250 participants were in depression, 60 per cent were unwilling to quit drugs, 80 per cent used alcohol, 70 per cent used marijuana and 20 per cent used heroin.

In the study carried out in Balkhu, there were more male IDUs (n=200) than females IDUs (n=20). Hence, prevalence of drug abuse was found high among the males. Most abusers were adolescent and 40% of them had a lifetime history of drug abuse. High levels of sexual risk were revealed among the IDUs of the study area. The IDUs used injection at the median age of 16.

Conclusions: In order to mitigate the risk of HIV transmission and substance abuse problems among the substance abusers of Kalanki, treatment policies should be improved together with the educational and intervention programs. In Balkhu, transmissions of infectious diseases have been the serious problems. Therefore, awareness raising, education, training, interaction and publicity is necessary in Balkhu area. Further research on depression and communicable diseases particularly HIV infection is highly desirable in both study areas.