Technical Specialist, Adolescent, under Project ACCELERATE, YRG CARE/JHU and currently serve voluntarily as the Vice Chair Indian Drug User Forum. HIV programming expertise in parts of India, on key populations and master's in social work with a progressive of experience of 16 years on public health.

Since April 2023, Manipur has faced severe disruptions due to ethnic conflict, curfews, and law enforcement challenges. These disturbances have significantly affected essential services, including HIV prevention and harm reduction efforts.
Reports suggest that drug use, particularly opioids and amphetamines, has surged among adolescents under 25 from communities involved in the conflict. A rapid situation assessment was conducted, utilizing 63 semi-structured interviews with adolescents aged 15 to 21 who inject drugs. This assessment aimed to understand the specific service needs of this population, focusing on access barriers amid the conflict.
Key findings from the assessment indicated severe challenges in accessing needle and syringe exchange programs (NSEP). Low-cost, low-quality drugs, along with online sales of illicit substances, were readily available. Among those interviewed, 73% had injected drugs within the last three months, with over half reporting heroin use for more than three years. Needle sharing was prevalent, with 57% admitting to sharing recently, and many sharing with five or more people. Notably, 20% of respondents lacked basic HIV/AIDS knowledge, while over 50% were unaware of sexually transmitted infections (STIs). Many adolescents resorted to obtaining injecting equipment from pharmacies, risking harassment or violence from vigilantes if found in possession of drug paraphernalia. Despite some awareness of HIV prevention, over 90% were reluctant to use services designed for adults.
Current harm reduction policies exclude adolescents under 18, leaving without critical support. However, advocacy efforts led to the establishment of Adolescent-Friendly Drop-in Centre (AFDIC) at a government hospital in Manipur, offering safe, confidential services tailored for young drug users.
Conclusion: Conflict has intensified the challenges faced by harm reduction services for adolescents in Manipur, heightening the risk of HIV and other harms. It is essential to advocate for safe spaces and age-specific services that address the unique needs of young people who use drugs.