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Developing Effective Health Interventions for Women Who Inject Drugs: Key Areas and Recommendations for Program Development and Policy

DOI: 10.1155/2012/269123

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Abstract:

Women who inject drugs face multiple gender-specific health risks and barriers to healthcare access. These gendered factors may contribute to elevated rates of HIV for this population. Though few countries systematically collect gender-disaggregated data related to injecting drug use, evidence indicates that there are large populations of women who inject drugs and who are in need of improved health services, including HIV prevention. Research on the effectiveness of interventions specifically tailored for women who inject drugs, along with the experience of programs working with this subpopulation, suggests that HIV risk practices need to be addressed within the larger context of women's lives. Multifaceted interventions that address relationship dynamics, housing, employment, and the needs of children may have more success in reducing risky practices than interventions that focus exclusively on injecting practices and condom use. Improved sexual and reproductive healthcare for women who use drugs is an area in need of development and should be better integrated into basic harm reduction programs. 1. Introduction There are significant differences in the health status and risk practices of female injecting drug users (IDUs) as compared to male IDU. A recent comprehensive review by the Reference Group to the United Nations (UN) on HIV and injecting drug use found that compared to their male counterparts, women who inject drugs experience significantly higher mortality rates, increased likelihood of injection-related problems, faster progression from first drug use to dependence, higher levels of risky injection and/or sexual risk behaviors, and higher rates of HIV [1]. Similarly, a systematic review of studies from 14 countries found a significantly higher prevalence of HIV among female IDU than among male IDU in settings with high HIV prevalence [2], and a review of studies in nine European Union countries found that the average HIV prevalence was more than 50% higher among female IDU than among their male counterparts [3]. Research on women who inject drugs comes mainly from North America, Western Europe, and Australia. Although there is a growing body of research on female IDU in low- and middle-income countries, to date there has been no systematic analysis of the prevalence of injecting drug use among women internationally, and data on women as a percentage of people who inject drugs is sparse. In the global data holdings on injection drug use and HIV maintained by the Reference Group to the UN on HIV and injection drug use, none of the countries

References

[1]  A. Roberts, B. Mathers, and Degenhardt on Behalf of the Reference Group to the United Nations on HIV and Injecting Drug Use, Women Who Inject Drugs: A Review of Their Risks, Experiences and Needs, National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia, 2010.
[2]  D. C. Des Jarlais, J. P. Feelemyer, S. N. Modi, K. Arasteh, and H. Hagan, “Are females who inject drugs at higher risk for HIV infection than males who inject drugs: an international systematic review of high seroprevalence areas,” Drug and Alcohol Dependence, vol. 124, no. 1-2, pp. 95–107, 2012.
[3]  European Monitoring Centre for Drugs and Drug Addiction, Annual Report 2006: The State of the Drugs Problem in Europe, European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal, 2012.
[4]  R. H. Needle and L. Zhao, HIV Prevention Among Injecting Drug Users: Strengthening U.S. Support for Core Interventions, CSIS Global Health Policy Center, Washington, DC, USA, 2010.
[5]  C. Stoicescu, Ed., The Global State of Harm Reduction 2012: Towards an Integrated Response, Harm Reduction International, London, UK, 2012.
[6]  Canadian Centre on Substance Abuse, “Injection drug users overview”.
[7]  Harm Reduction International, What is Harm Reduction: a position statement, Harm Reduction International, London, UK, 2012, http://www.ihra.net/what-is-harm-reduction.
[8]  WHO, UNODC, and UNAIDS, Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users, World Health Organization, Geneva, Switzerland, 2009.
[9]  H. I. V. International /AIDS Alliance, Good Practice Guide: HIV and Drug Use: Community Responses to Injecting Drug Use and HIV, International HIV/AIDS Alliance, Hove, UK, 2010.
[10]  A. Shapoval and S. Pinkham, “Women and harm reduction in central Asia,” Tech. Rep., Abt Associates, 2011, Quality Health Care Project in the Central Asian Republics.
[11]  S. Pinkham and K. Malinowska-Sempruch, Women, Harm Reduction, and HIV, International Harm Reduction Development Program of the Open Society Institute, New York, NY, USA, 2007.
[12]  H. Fair, “International review of women's prisons,” Prison Service Journal, no. 184, pp. 3–8, 2009.
[13]  K. Burns, Women, Harm Reduction, and HIV: Key Findings from Azerbaijan, Georgia, Kyrgyzstan, Russia, and Ukraine, International Harm Reduction Development Program of the Open Society Institute, New York, NY, USA, 2009.
[14]  European Collaborative Study in EuroCoord, H. Bailey, C. Townsend, M. Cortina-Borja, and C. Thorne, “Insufficient antiretroviral therapy in pregnancy: missed opportunities for prevention of mother-to-child transmission of HIV in Europe,” Antiviral Therapy, vol. 16, no. 6, pp. 895–903, 2011.
[15]  R. MacRae and E. Aalto, “Gendered power dynamics and HIV risk in drug-using sexual relationships,” AIDS Care, vol. 12, no. 4, pp. 505–515, 2000.
[16]  M. C. Doherty, R. S. Garfein, E. Monterroso, D. Brown, and D. Vlahov, “Correlates of HIV infection among young adult short-term injection drug users,” AIDS, vol. 14, no. 6, pp. 717–726, 2000.
[17]  C. A. Latkin, W. Mandell, A. R. Knowlton et al., “Gender differences in injection-related behaviors among injection drug users in Baltimore, Maryland,” AIDS Education and Prevention, vol. 10, no. 3, pp. 257–263, 1998.
[18]  M. W. Tyndall, R. S. Hogg, M. T. Schechter, and E. Wood, “Requiring help injecting independently predicts incident HIV infection in a prospective cohort study of injection drug users,” in Proceedings of the 15th International AIDS Conference, Bangkok, Thailand, 2004.
[19]  W. M. Wechsberg, W. Luseno, K. Riehman, R. Karg, F. Browne, and C. Parry, “Substance use and sexual risk within the context of gender inequality in South Africa,” Substance Use & Misuse, vol. 43, no. 8-9, pp. 1186–1201, 2008.
[20]  N. El-Bassel, L. Gilbert, S. Witte, E. Wu, and M. Chang, “Intimate partner violence and HIV among drug-involved women: contexts linking these two epidemics-challenges and implications for prevention and treatment,” Substance Use & Misuse, vol. 46, no. 2-3, pp. 295–306, 2011.
[21]  M. Engstrom, N. El-Bassel, and L. Gilbert, “Childhood sexual abuse characteristics, intimate partner violence exposure, and psychological distress among women in methadone treatment,” Journal of Substance Abuse Treatment, vol. 43, no. 3, pp. 366–276, 2012.
[22]  C. J. Boyd, “The antecedents of women's crack cocaine abuse: family substance abuse, sexual abuse, depression and illicit drug use,” Journal of Substance Abuse Treatment, vol. 10, no. 5, pp. 433–438, 1993.
[23]  R. C. Freeman, K. Collier, and K. M. Parillo, “Early life sexual abuse as a risk factor for crack cocaine use in a sample of community-recruited women at high risk for illicit drug use,” American Journal of Drug and Alcohol Abuse, vol. 28, no. 1, pp. 109–131, 2002.
[24]  D. Kaysen, T. M. Dillworth, T. Simpson, A. Waldrop, M. E. Larimer, and P. A. Resick, “Domestic violence and alcohol use: trauma-related symptoms and motives for drinking,” Addictive Behaviors, vol. 32, no. 6, pp. 1272–1283, 2007.
[25]  R. D. Weiss, M. L. Griffin, and S. M. Mirin, “Drug abuse as self-medication for depression: an empirical study,” American Journal of Drug and Alcohol Abuse, vol. 18, no. 2, pp. 121–129, 1992.
[26]  D. E. Grice, K. T. Brady, L. R. Dustan, R. Malcolm, and D. G. Kilpatrick, “Sexual and physical assault history and posttraumatic stress disorder in substance-dependent individuals,” American Journal on Addictions, vol. 4, no. 4, pp. 297–305, 1995.
[27]  N. El-Bassel, L. Gilbert, R. Schilling, and T. Wada, “Drug abuse and partner violence among women in methadone treatment,” Journal of Family Violence, vol. 15, no. 3, pp. 209–228, 2000.
[28]  V. Frye, N. El-Bassel, L. Gilbert, V. Rajah, and N. Christie, “Intimate partner sexual abuse among women on methadone,” Violence and Victims, vol. 16, no. 5, pp. 553–564, 2001.
[29]  R. A. Sansone, J. Chu, and M. W. Wiederman, “Self-inflicted bodily harm among victims of intimate-partner violence,” Clinical Psychology & Psychotherapy, vol. 14, no. 5, pp. 352–357, 2007.
[30]  T. Matsumoto, K. Kosaka, A. Yamaguchi, et al., “Eating disorders in female substance use disorders: a preliminary research on the relationship of substances and eating behaviors,” Clinical Psychiatry, vol. 45, no. 2, pp. 119–127, 2003.
[31]  N. El-Bassel, L. Gilbert, E. Wu, H. Go, and J. Hill, “Relationship between drug abuse and intimate partner violence: a longitudinal study among women receiving methadone,” American Journal of Public Health, vol. 95, no. 3, pp. 465–470, 2005.
[32]  J. C. Campbell, M. L. Baty, R. M. Ghandour, J. K. Stockman, L. Francisco, and J. Wagman, “The intersection of intimate partner violence against women and HIV/AIDS: a review,” International Journal of Injury Control and Safety Promotion, vol. 15, no. 4, pp. 221–231, 2008.
[33]  A. Ordean, D. Midmer, L. Graves, S. Payne, and G. Hunt, PRIMA (Pregnancy-Related Issues in the Management of Addictions): A Reference for Care Providers, Department of Family & Community Medicine, University of Toronto, Toronto, Canada, 2008.
[34]  United Nations Office on Drugs and Crime (UNODC), Substance Abuse Treatment and Care for Women: Case Studies and Lessons Learned, UN, New York, NY, USA, 2004.
[35]  A. H. Kral, J. Lorvick, R. N. Bluthenthal, and J. K. Watters, “HIV risk profile of drug-using women who have sex with women in 19 United States cities,” Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 16, no. 3, pp. 211–217, 1997.
[36]  J. Absalon, C. M. Fuller, D. C. Ompad et al., “Gender differences in sexual behaviors, sexual partnerships, and HIV among drug users in New York City,” AIDS and Behavior, vol. 10, no. 6, pp. 707–715, 2006.
[37]  R. M. Young, S. R. Friedman, and P. Case, “Exploring an HIV paradox: an ethnography of sexual minority women injectors,” Journal of Lesbian Studies, vol. 9, no. 3, pp. 103–116, 2005.
[38]  R. M. Young, S. R. Friedman, P. Case, M. W. Asencio, and M. Clatts, “Women injection drug users who have sex with women exhibit increased HIV infection and risk behaviors,” Journal of Drug Issues, vol. 30, no. 3, pp. 499–524, 2000.
[39]  M. E. Epele, “Gender, violence and HIV: women's survival in the streets,” Culture, Medicine and Psychiatry, vol. 26, no. 1, pp. 33–54, 2002.
[40]  P. E. Estebanez, N. K. Russell, M. D. Aguilar et al., “Women, drugs and HIV/AIDS: results of a multicenter European study,” International Journal of Epidemiology, vol. 29, no. 4, pp. 734–743, 2000.
[41]  UNAIDS, UNAIDS Guidance Note on HIV and Sex Work, UNAIDS, Geneva, Switzerland, 2009.
[42]  K. I. Black, C. Stephens, P. S. Haber, and N. Lintzeris, “Unplanned pregnancy and contraceptive use in women attending drug treatment services,” Australian and New Zealand Journal of Obstetrics and Gynecology, vol. 52, no. 2, pp. 146–150, 2012.
[43]  S. Pinkham and A. Shapoval, Making Harm Reduction Work for Women: The Ukrainian Experience, International Harm Reduction Development Program, Open Society Institute, New York, NY, USA, 2010.
[44]  S. Murphy and M. Rosenbaum, Pregnant Women on Drugs: Combating Stereotypes and Stigma, Rutgers University Press, New Brunswick, NJ, USA, 1999.
[45]  L. A. Paltrow, “Punishment and prejudice: judging drug-using pregnant women,” in Mother Troubles, J. E. Hanigsberg and S. Riddick, Eds., Beacon Press, 1999.
[46]  Eurasian Harm Reduction Network and Canadian HIV/AIDS Legal Network and E.V.A., “Violations of the rights to reproductive health and of women who use drugs in Russian Federation,” Communication to the UN Commission on the Status of Women, 2012.
[47]  Eurasian Harm Reduction Network, “Violation of the right to health and reproductive choice in Ukraine,” Communication to the UN Commission on the Status of Women, 2012.
[48]  A. Sarang and Andrei Rylkov Foundation, “I v glazakh ya byla konchennyi chelovek,” 2011, http://rylkov-fond.org/blog/lichnye-svidetelstva/kaliningrad-hiv-story/.
[49]  WHO and UNODC, UNAIDS Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users, World Health Organization, Geneva, Switzerland, 2009.
[50]  American Civil Liberties Union and The Brennan Center, and Break the Chains, Caught in the Net: The Impact of Drug Policies on Women and Families, 2012.
[51]  Eurasian Harm Reduction Network, Women and Drug Policy in Eurasia, EHRN, Vilnius, Lithuania, 2010.
[52]  WHO-Euro and UNODC, Women's Health in Prison: Correcting Gender Inequity in Prison Health, WHO-Euro, Copenhagen, Denmark, 2009.
[53]  UNODC and UNAIDS, Women and HIV in Prison Settings, UNODC, Vienna, Austria.
[54]  Columbia Human Rights Law Review, “Special issues of women prisoners,” in A Jailhouse Lawyer's Manual, 2011.
[55]  K. Willis and C. Rushforth, “The female criminal: an overview of women's drug use and offending behavior,” in Trends and Issues in Crime and Criminal Justice, Australian Institute of Criminology, Canberra, Australia, 2003.
[56]  E. Iakobishvili, Cause for Alarm: The Incarceration of Women for Drug Offences in Europe and Central Asia, and the Need for Legislative and Sentencing Reform, International Harm Reduction Association/Harm Reduction International, London, UK, 2012.
[57]  Quaker Council for European Affairs, Women in Prison, 2007, http://www.qcea.org/wp-content/uploads/2011/04/rprt-wip1-main-en-feb-2007.pdf.
[58]  WHO, UNODC, and UNAIDS, “Interventions to address HIV in Prisons: comprehensive review,” Evidence for Action Technical Paper, WHO, Geneva, Switzerland, 2007.
[59]  D. J. Javakhishvili, N. Balanchivadze, I. Kirtadze, et al., “Overview of the drug situation in Georgia, 2012,” Georgian Country Situation Summary, 2012.
[60]  R. J. Wolitski, D. P. Kidder, and K. A. Fenton, “HIV, homelessness, and public health: critical issues and a call for increased action,” AIDS and Behavior, vol. 11, supplement 2, pp. 167–171, 2007.
[61]  L. Maher, Sexed Work: Gender, Race, and Resistance in a Brooklyn Drug Market, Oxford University Press, New York, NY, USA, 1997.
[62]  A. Taylor, Women Drug Users: An Ethnography of a Female Injecting Community, Clarendon Press, Oxford, UK, 1993.
[63]  D. German and C. A. Latkin, “Social stability and HIV risk behavior: evaluating the role of accumulated vulnerability,” AIDS and Behavior, vol. 16, no. 1, pp. 168–178, 2012.
[64]  E. L. Gollub, “A neglected population: drug-using women and women's methods of HIV/STI prevention,” AIDS Education and Prevention, vol. 20, no. 2, pp. 107–120, 2008.
[65]  N. Palmateer, J. Kimber, M. Hickman, S. Hutchinson, T. Rhodes, and D. Goldberg, “Evidence for the effectiveness of sterile injecting equipment provision in preventing hepatitis C and human immunodeficiency virus transmission among injecting drug users: a review of reviews,” Addiction, vol. 105, no. 5, pp. 844–859, 2010.
[66]  WHO, UNODC, and UNAIDS, Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users: Updated 2012, World Health Organization, Geneva, Switzerland, 2012.
[67]  M. Latka, “Drug-using women need comprehensive sexual risk reduction interventions,” Clinical Infectious Diseases, vol. 37, supplement 5, pp. S445–S450, 2003.
[68]  S. Semaan, D. C. Des Jarlais, and R. Malow, “Behavior change and health-related interventions for heterosexual risk reduction among drug users,” Substance Use and Misuse, vol. 41, no. 10—12, pp. 1349–1378, 2006.
[69]  J. Gay, K. Hardee, M. Croce-Galis, et al., What Works for Women and Girls: Evidence for HIV/AIDS Interventions, Open Society Institute, New York, NY, USA, 2010.
[70]  W. M. Wechsberg, E. Krupitsky, T. Romanova, et al., “Double jeopardy—drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial,” Substance Abuse Treatment, Prevention, and Policy, vol. 7, no. 1, pp. 1–11, 2012.
[71]  S. G. Sherman, D. German, Y. Cheng, M. Marks, and M. Bailey-Kloche, “The evaluation of the JEWEL project: an innovative economic enhancement and HIV prevention intervention study targeting drug using women involved in prostitution,” AIDS Care, vol. 18, no. 1, pp. 1–11, 2006.
[72]  M. S. Kumar and M. Sharma, “Women and substance use in India and Bangladesh,” Substance Use & Misuse, vol. 43, no. 8-9, pp. 1062–1077, 2008.
[73]  O. S. Ashley, M. E. Marsden, and T. M. Brady, “Effectiveness of substance abuse treatment programming for women: a review,” American Journal of Drug and Alcohol Abuse, vol. 29, no. 1, pp. 19–53, 2003.
[74]  W. Sword, S. Jack, A. Niccols, K. Milligan, J. Henderson, and L. Thabane, “Integrated programs for women with substance use issues and their children: a qualitative meta-synthesis of processes and outcomes,” Harm Reduction Journal, vol. 6, article 32, 2009.
[75]  Open Society Foundations, “By women, for women: new approaches to harm reduction in Russia,” Fact Sheet, Open Society Institute, 2011.
[76]  B. Morse, S. Gehshan, and E. Hutchins, Screening for Substance Abuse During Pregnancy: Improving Care, Improving Health, National Center for Education in Maternal and Child Health, Arlington, Va, USA, 2000.
[77]  D. Wolfe, M. P. Carrieri, and D. Shepard, “Treatment and care for injecting drug users with HIV infection: a review of barriers and ways forward,” The Lancet, vol. 376, no. 9738, pp. 355–366, 2010.
[78]  M. Thumath, “Creating the village for women who use drugs and their families: lessons from the pregnancy outreach project sheway,” in Developing Services for Women Who Use Drugs (Training Module), Eurasian Harm Reduction Network, Ed., 2009.
[79]  R. Jurgens, “Nothing About Us Without Us”: Greater, Meaningful Involvement of People Who Use Illegal Drugs: A Public Health, Ethical, and Human Rights Imperative, Canadian HIV/AIDS Legal Network, International HIV/AIDS Alliance, Open Society Institute, 2008.
[80]  Global Coalition on Women and AIDS, Women Who Use Drugs, Harm Reduction and HIV, GCWA, Geneva, Switzerland, 2011.
[81]  J. Fellner and P. Vinck, “Targeting blacks: drug law enforcement and race in the United States,” 2008, http://www.hrw.org/en/node/62236/section/1.
[82]  R. N. Bluthenthal, J. Lorvick, A. H. Kral, E. A. Erringer, and J. G. Kahn, “Collateral damage in the war on drugs: HIV risk behaviors among injection drug users,” International Journal of Drug Policy, vol. 10, no. 1, pp. 25–38, 1999.
[83]  L. Degenhardt, W. T. Chiu, N. Sampson et al., “Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO world mental health surveys,” PLoS Medicine, vol. 5, no. 7, pp. 1053–1067, 2008.
[84]  R. Jürgens, A. Ball, and A. Verster, “Interventions to reduce HIV transmission related to injecting drug use in prison,” The Lancet Infectious Diseases, vol. 9, no. 1, pp. 57–66, 2009.
[85]  P. Reuter, “Ten years after the United Nations general assembly special session (UNGASS): assessing drug problems, policies and reform proposals,” Addiction, vol. 104, no. 4, pp. 510–517, 2009.
[86]  S. A. Strathdee, T. B. Hallett, N. Bobrova et al., “HIV and risk environment for injecting drug users: the past, present, and future,” The Lancet, vol. 376, no. 9737, pp. 268–284, 2010.
[87]  T. Rhodes, M. Singer, P. Bourgois, S. R. Friedman, and S. A. Strathdee, “The social structural production of HIV risk among injecting drug users,” Social Science & Medicine, vol. 61, no. 5, pp. 1026–1044, 2005.

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