%0 Journal Article
%T HIV Prevention and Rehabilitation Models for Women Who Inject Drugs in Russia and Ukraine
%A Roman Yorick
%A Halyna Skipalska
%A Svetlana Suvorova
%A Olga Sukovatova
%A Konstantin Zakharov
%A Sara Hodgdon
%J Advances in Preventive Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/316871
%X Women who inject drugs require gender-specific approaches to drug rehabilitation, modification of risk behaviors, and psychosocial adaptation. Improved outcomes have been demonstrated when the specific needs of women＊s subpopulations have been addressed. Special services for women include prenatal care, child care, women-only programs, supplemental workshops on women-focused topics, mental health services, and comprehensive programs that include several of the above components. To address the special needs of women injecting drug user (IDU) subpopulations, such as HIV-positive pregnant women and women with young children, recently released female prisoners, and street-involved girls and young women, HealthRight International and its local partners in Russia and Ukraine have developed innovative service models. This paper presents each of these models and discusses their effectiveness and implementation challenges specific to local contexts in Russia and Ukraine. 1. Introduction The prevalence of injecting use of opioid substances among people 15每64 years of age is estimated at 0.9% in Ukraine and 2.29% in Russia [1]. There is no reliable data on gender distribution of IDUs in the region. Global trends suggest that drug use in general is more prevalent among boys and men than among girls and women [2]. Some data from the region demonstrate that women constitute between 20 and 30% of IDUs [3, 4]. The HIV epidemic in Russia has been closely linked with IDU: 56.2每61.3% of newly reported HIV infections in 2008每2011 were attributed to IDUs [5]. In Ukraine, heterosexual sex has been the predominant route of HIV transmission since 2008, but drug use is still a key force in the epidemic, with 38.4% of new infections occurring in IDUs in 2011 [6]. The midestimates of HIV prevalence in IDUs in the region are close to 40% [7]. Female sub-populations with the highest prevalence of injecting drug use and HIV in the region include commercial sex workers (CSWs) and those who engage in transactional sex, street-involved girls and young women, and prisoners. These groups are highly intertwined. Among CSWs, 18每70% inject drugs [8每10]; among IDUs, some 40% report transactional sex [11]. Among street children and youth, approximately one-third are female; 20每50% have experience of injecting drug use, and 5每10% report transactional sex [12每14]. Women constitute 5.3% and 8.2% of the prison populations in Russia and Ukraine, or 60 and 8 thousand women prisoners, respectively [15]. There are no reliable national data on the proportion of IDUs among prisoners in the region. In
%U http://www.hindawi.com/journals/apm/2012/316871/