Behavioral and psychosocial outcomes of harm reduction interventions among people who inject drugs: a mixed-methods study from India

Background Harm reduction interventions, including Opioid Substitution Therapy (OST), play a crucial role in addressing high-risk injecting behaviors and improving health outcomes among people who inject drugs (PWID). However, evidence on their combined behavioral and psychosocial impact remains limited in the Indian context.Methods This study adopted a mixed-methods design involving 60 participants enrolled in harm reduction programs. Quantitative data were collected using the Injecting Risk Questionnaire (IRQ) to assess risk behaviors and the WHO Quality of Life-BREF (WHOQOL-BREF) to measure quality of life across multiple domains. Qualitative data were gathered to explore participants’ lived experiences and recovery processes.Results The findings indicated a statistically significant reduction in injecting risk injecting behaviors following the intervention (p < 0.01). Participants also demonstrated notable improvements in quality of life across, physical, psychological, social, and environmental domains. Mixed ANOVA results confirmed significant time effects, suggesting overall improvement after intervention exposure. Qualitative insights underscored the importance of counseling, peer support, and family reintegration in facilitating behavioral change.Conclusion Harm reduction approaches are effective in promoting safer behaviors and enhancing psychosocial well-being among PWID. Integrated interventions that combine pharmacological treatment with psychosocial support are essential for sustaining long-term recovery outcomes. Strengthening harm reduction program can contribute significantly contribute to HIV prevention and improved quality of life among vulnerable populations.