CHAPTER 1: Reducing HIV Prevalence Through Promoting and Sustaining Behaviour Change among People Who Inject Drugs (PWlDs) in Nigeria by Boniface Oguche, Udeme Peter-ljeh, Bede Eziefule

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Introduction
People Who Inject Drugs (PWIDs) are individuals (male or female) who indulge in this behaviour for recreational or non-therapeutic purposes. Most people who inject drugs fall between the age range of 15 and 49. Accurate knowledge of HIV amongst them is relatively low (30.7%). Risk perception is also generally low with just about 23% considering themselves to be at risk of contracting HIV. Of these, 19.4% thought they were at risk because they inject narcotics, whilst 29. 1% thought it was because they do not always use a condom. PWIDS contribute to 9% of the annual new infections (IBBSS, 2010).
Injecting Drug use is predominantly a male habit, however there are also female People who Inject Drugs. HIV Prevalence rate among PWIDs is 4.2%.with prevalence among female WlDs about 7 times higher than amongst their male counterparts. About 38.1% of female WIDs prostituted in the past 12 months. PWIDs, especially females are generally unexposed and hard to reach. They are a highly mobile group with distinct identities and social roles that go beyond injecting drugs and sexual practices.
The habit of injecting drugs is often associated with high rate of criminal involvement, low risk perception and poor health-seeking behaviour (IBBSS 2010). The project “scaling up Gender-sensitive HIV/AIDS prevention, treatment, care and support interventions for Mo.st At- Risk Populations in Nigeria ”currently being implemented by Center for the Rights to Health (CRH) under the Global Fund Round 9 phase 2 is used as a case study for this paper. Its objectives seek to focus on reducing HIV prevalence among PWID by promoting behaviour change through education in order to increase accurate knowledge, increase early Sexually Transmitted Infections (STIs) detection, treatments and partner notification. Moreover, it also aims at increasing HIV counseling and testing Uptake, consistent and correct condom use, as well as reduce related stigma and discrimination.
Furthermore, this paper has been developed based on field experiences and feedback from the CRH Implemented project. It seeks to promote good practices as well as highlight major gaps that could improve programming for PWID in Nigeria.

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