Drug-users raise risk of HIV in India's heartland

India's injecting drug problem may be worse than thought, a new survey of the country's breadbasket region shows, worrying health experts and activists who say it could fuel the spread of HIV and AIDS.

The UNAIDS-backed survey by the Society for Promotion of Youth and Masses (SPYM) -- a group fighting drug abuse -- showed that nearly 60 percent of 3,300 drug users in 10 cities and towns in the northern states of Punjab and Haryana shared needles and syringes.

The prosperous region -- home to around 50 million people -- was not known for injecting drug users (IDUs), and the survey is the first large-scale mapping in the area.

"This shows the problem of IDUs has been underestimated in mainland India, as most of the problem was thought to be in the northeast," Denis Broun, the India head of UNAIDS, the United Nations AIDS agency, told Reuters.

Official estimates say there are about 200,000 IDUs in India, a figure activists say is a huge underestimate. The problem is seen as most acute in the remote northeast, which borders Myanmar and the opium-producing Golden Triangle.

India has the world's largest number of people living with HIV with 5.7 million people thought to be infected, although findings of a new population-based national survey have indicated that the actual figure could be lower.

In other parts of Asia, injecting drug use has fuelled the HIV epidemic. But India's state-run National AIDS Control Organization (NACO) says drug users are responsible for just 2.2 percent of HIV transmissions.

UNAIDS says this number may now need to be looked at again.

"This survey points out that the IDU transmission figure is likely to be higher than 2.2 percent," Broun said. "The percentage for IDU transmissions may be relatively small but if there are more IDUs than thought, it could be a major transmission route in the future."

Many drug users in India are married or visit sex workers, presenting an HIV risk to their partners, Broun added.