Organized by the UNODC HIV/AIDS Section and the Academic Council on the United Nations System in partnership with the International Network of Women who use Drugs and Women and Harm Reduction International Network.

Introduction

Women who use drugs are more likely than men to contract HIV. Women are faced with unique challenges for socio-economic reasons, but also due to reasons related to pregnancy and so on.

Harm reduction is usually oriented toward males.

Dr. Gilberto Gerra, UNODC

In 20 years of seeing 900 drug dependent people per year, the proportion of women has risen from 1 in 7 to 1 in 3. Most females are affected by depression, partly created by their drug dependence. This is exacerbated by neglect from society and stigmatisation, the latter of which women suffer from more due to the societal construct of what a woman should be; for example, a good mother etc.

There is a big issue on sexual abuse. In studies we’re seeing that about 36% of female patients at drug services have been sexually abused in their lives.

Human trafficking is another intertwined issue. Women and girls who are forced into prostitution are either forced onto, or turn to drugs to escape their situation. Similarly intertwined issues are domestic violence and harassment.

Key questions are:

• What are the barriers to accessing services for women?
• How do we tailor the needs of the female patient?
• How do we protect women who are engaged in sex work, ensuring they have a safe space to carry out their work and are free from being harassed by law agencies?

Female health professionals providing services for women suffering from addiction have been shown to be more effective.

Comment from Sylvia, Kenya AIDS Forum
 
We’ve seen that it may not always be the case that women require a female health professional; what’s needed is just a proper assessment of what the woman requires, what she feels comfortable with. It can simply be a case of building a relationship with the patient, not necessarily having a female doctor.

Comment from Dylan O’Sullivan, World Hepatitis Alliance

Is testing for hepatitis something that is encouraged automatically, given that the risk of co-infection among people with HIV is great?

Ruth Birgin, harm reduction specialist, former consultant with WHO, among others
 
Women are disproportionately affected by punitive drug policy, setting the scene for HIV transmission.The INCB encourages governments to adopt a strict interpretation of the drug conventions which represents an an enormous barrier to women suffering from drug addiction. Criminalisation of drug use severely hinders access to treatment services.

1) Incarceration

Women are more represented in prison around the world than ever before due to punitive drug laws. However, as men comprise the majority, the harm reduction service available to women are comparatively poor.

In certain countries, prison guards exploit incarcerated women, hindering their access to proper treatment and in cases physically and sexually abusing them.

2) Child Custody & Pregnancy

Drug use does not by definition make a woman a bad mother, but this is how society may view it, increasing stigmatisation and hindering access to services. This impacts negatively on care of the child.

Pregnant women are equally subject to stigmatisation if suffering from drug addiction, and therefore may not seek help, or may not be offered it.

Addressing consequences of punitive policy

It’s necessary that women who use drugs be meaningfully involved in policy design and service provision. Drug use and sex work should be decriminalised to remove obstacles to treatment services.

Dasha Ocheret, Eurasian HRN

It’s one of the first times I’ve been able to come to Vienna and share something positive on this issue.

In the last year, our organisation has formally launched the campaign Women Against Violence which involves an online platform where women can register cases of police violence. In the first year there were over 500 cases registered. Is this a lot, or not?

The issue of police violence is really a hidden one. Where countries have registered a higher number of cases of police violence via our platform, it may not be indicative of more police violence, but rather representative of a more active civil society helping to make women aware of this issue and how they can raise it.

To ensure success, we organised scholarships for female activists to build advocacy, provided small grants for women who use drugs, and provided regular online seminars on human rights. Furthermore, support was given for developing partnerships.

A lot of support has been provided by UNODC in certain countries.

Our aim is not just to document what is happening, but ultimately to decrease police violence. There is currently an imbalance and disconnect between, say, harm reduction workers and police. Our campaign is trying to foster relationships between all groups involved to work toward improving the situation.

The first step is to register cases of violence. Then, we move onto engaging with police on the topic. The initial reaction from police was quite negative and not much interest to cooperate. However, when you do it for a second and third time, interest materialises. We are starting to see more positive interaction between harm reduction providers and police officers.

Parviz Afshar, Drug Control Headquarters, Iran

There are 1.3 million drug users in Iran, based on 2010 figures. Around 10% of these are women.

Regarding available services for women, there are female drop-in centres providing: needle exchange, condoms, OST, education, and counselling, among others.

Short-term residential centres for women provide mostly abstinence based rehabilitation. There are also women only methadone maintenance centres; there are almost 50,000 women on MMT currently. These centres also provide counselling and education.

Comment from Sylvia, Kenya AIDS Forum

We’ve seen cases in the country of women who use drugs in some cases selling their children — partly driven by stigmatisation of them — and forced sterilisation due to the extreme attitude of authorities against female drug users.

Comment from Dasha Ocheret

The work being done by the UNODC on this issue if great, but we’re not seeing the same level of commitment from Geneva and the Global Fund. We need to, therefore, work toward setting up technical assistance between countries to ensure that Global Fund aid is used to properly combat the problems faced by women in terms of violence and drug use.