Abstract

Background:People who inject drugs (PWID) are at high risk of acquiring blood-borne viral infections due to unsafe injection practices and overlapping sexual risk behaviors. In India, HIV, Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) continue to pose major public health challenges, with considerable regional variation in prevalence. This study aimed to determine the prevalence of these infections and associated risk factors among PWID in northern India.

Methods : A cross-sectional observational study was conducted between September 2024 and June 2025 at a de-addiction and health center in Tarn Taran and faridkot Punjab. A total of 300 PWID aged ≥18 years were recruited. Data on demographics, duration of drug use, and risk behaviors were collected using a structured proforma. Screening for HIV, HBV, and HCV was performed with rapid card tests, followed by confirmatory ELISA, and PCR for HCV RNA. Associations between risk factors and infection status were assessed using chi-square tests

Results:The mean age of participants was 30.1 ± 6.3 years, and 97.7% were male. Viral infections were detected in 47% of participants: HCV in 37.3%, HBV in 7.3%, and HIV in 1%. Co-infections occurred in 6%, including one case of triple infection. Needle sharing (p=0.02) and longer duration of drug use (p=0.03) were significantly associated with infection. Unsafe sexual practices showed a non-significant association with HIV positivity.

Conclusion:This study reveals a very low HIV but moderate HCV and notable HBV burden among PWID in northern India. Strengthening harm-reduction strategies, ensuring HBV vaccination, and expanding access to HCV diagnostics and treatment are essential to curb the ongoing transmission of blood-borne viral infections in this high-risk group.