ArticleBMJ open2021
Young and invisible: a qualitative study of service engagement by people who inject drugs in India.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- Trial
- Differential risk for Hepatitis C and HIV among people who inject drugs in Kenya: a latent class analysis signaling needs for innovation in service delivery.The International journal on drug policy · 2025Article
- Linkage to hepatitis C virus care in a binational cohort study of People who inject drugs on the U.S.-Mexico border.The International journal on drug policy · 2025Article
- "We're Not Gonna Aid You in Shooting Up": Stigma's Relationship to Harm Reduction in People Who Inject Drugs.Journal of general internal medicine · 2025Article
- Trajectories of medication for opioid use disorder and their impact on HIV testing among people who inject drugs in India: A longitudinal assessment of clinic-based data.Addiction (Abingdon, England) · 2025Article
- Expanding single-venue services to better engage young people who inject drugs: insights from India.Harm reduction journal · 2024Review
- A retrospective study of tuberculosis prevalence and associated factors among HIV-positive key populations in Nigeria.PLOS global public health · 2024Article
- Buprenorphine treatment receipt characteristics and retention among people who inject drugs at Integrated Care Centers in India.Drug and alcohol dependence · 2023Article
- Combating illicit fentanyl: Will increased Chinese regulation generate a public health crisis in India?Frontiers in public health · 2022Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 3 countries.
Funding
Abstract
objectivesThe HIV epidemic in India is concentrated in key populations such as people who inject drugs (PWID). New HIV infections are high among young PWID (≤30 years of age), who are hard to engage in services. We assessed perspectives of young PWID to guide development of youth-specific services.
settingWe conducted focus group discussions (FGDs) with PWID and staff at venues offering services to PWID in three Indian cities representing historical and emerging drug use epidemics.
participantsPWID were eligible to participate if they were between 18 and 35 years, had initiated injection as adolescents or young adults and knew adolescent PWID in their networks. 43 PWID (81% male, 19% female) and 10 staff members participated in FGDs. A semistructured interview guide was used to elicit participants' narratives on injection initiation experiences, barriers to seeking harm reduction services, service delivery gaps and recommendations to promote engagement. Thematic analysis was used to develop an explanatory model for service engagement in each temporal stage across the injection continuum.
resultsInjection initiation followed non-injection opioid dependence. Lack of services for non-injection opioid dependence was a key gap in the preinjection initiation phase. Lack of knowledge and reliance on informal sources for injecting equipment were key reasons for non-engagement in the peri-injection phase. Additionally, low-risk perception resulted in low motivation to seek services. Psychosocial and structural factors shaped engagement after established injection. Housing and food insecurity, and stigma disproportionately affected female PWID while lack of confidential adolescent friendly services impeded engagement by adolescent PWID.
conclusionsDevelopment of youth-specific services for young PWID in India will need to address unique vulnerabilities and service gaps along each stage of the injection continuum. Scaling-up of tailored services is needed for young female PWID and adolescents, including interventions that prevent injection initiation and provision of confidential harm reduction services.
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