Blankenship, K.M., Reinhard, E., Sherman, S.G., and El-Bassel, N. Journal of Acquired Immune Deficiency Syndromes (June 2015), doi: 10.1097/QAI.0000000000000638.
The authors provided a global overview of contextual sources of HIV risk among women who use drugs (WWUD) and structural interventions (SIs) to address WWUDs' vulnerability to HIV. They argued that there is a need to modify SIs to meet the needs of WWUDs—for example, engaging more women's peer networks—and identified challenges to policies that affect WWUD disproportionately, if not exclusively. Additions to existing harm reduction programs, such as providing on-site child care; employing female, nonjudgmental staff; offering mobile services; and being located in relatively safe and discreet areas, can make these programs more accessible to women. Additionally, given the potentially harsher consequences to women of revealing their drug use, and their reluctance to interact with men (possibly ensuing from histories of abuse), SIs for WWUD have also involved offering “women-only” hours and services, such as women-only drug treatment programs. The authors suggested that a potentially powerful set of SIs for WWUD could integrate health and social service models, such as “one-stop shops” that enable WWUD to access multiple services at one site. Thus, women could receive a constellation of services at a single site, including harm reduction; screening, treatment, and care for substance use, HIV, tuberculosis, hepatitis, sexually transmitted infections, mental health, trauma, and interpersonal violence; and other physical, social, and emotional health services.