Awareness of HIV/AIDS among People who Inject Drugs in two Districts of Kashmir,India

Background: Injecting drug use is a significant driver of the HIV/AIDS epidemic, yet limited data exist on awareness, behaviors, and risk perceptions among people who inject drugs (PWID) in Kashmir. This study aimed to assess the knowledge of HIV/AIDS transmission and prevention, determine injecting practices, and evaluate self-assessed HIV risk among PWID in the districts of Srinagar and Baramulla, Jammu and Kashmir. Methods: A cross-sectional study was conducted among male PWID registered at High-Risk Group (HRG) intervention sites under the Jammu and Kashmir AIDS Control Society (JKACS). Participants were selected using simple random sampling from the registry, with a calculated sample size (407). Data were collected through structured interviews, focusing on HIV/AIDS knowledge, injecting behaviors, and perceived risk of HIV infection. Results: While 76.7% of participants were aware of HIV, comprehensive knowledge was demonstrated by only 57%. Misconceptions were prevalent: 66.9% equated HIV with AIDS, 30.8% believed AIDS is curable, and 46.8% thought a healthy diet could prevent HIV. Stigmatizing views persisted, with 80.2% perceiving HIV as confined to high-risk groups. Risky injecting practices were alarmingly common, with 68.3% reporting needle reuse, 69.7% sharing needles during their last injection, and 83.8% relying on ineffective water cleaning methods. Sexual practices further elevated HIV risk, with only 28% consistently using condoms, 21.9% reporting multiple partners, and 20.3% engaging in transactional sex. Self-assessed HIV risk revealed varied perceptions, with 25.8% considering themselves "very likely" to contract HIV, 35.4% underestimating their risk, and 37.5% rarely or never reflecting on it. Conclusions: The study underscores critical gaps in HIV/AIDS knowledge, widespread high-risk injecting practices, and inconsistent risk perception among PWID in Kashmir. These findings highlight the urgent need for culturally tailored harm reduction programs that address misconceptions, promote safer injecting behaviors, and enhance HIV risk awareness in this vulnerable population.