Women who use drugs need non-judgemental support that provides access to the same type of services that other vulnerable women need alongside drug-specific harm reduction services.

These services might include sexual and reproductive healthcare, including abortion care and HIV prevention services (e.g. condoms, lubricants and PrEP), sexual and gender-based violence services, livelihood support and feminine hygiene kits. Women who use drugs may also need housing and food support and safe places to wash and change sanitary products if they are homeless.

Harm reduction services may include ‘women-only’ clinics or outreach, free childcare during appointments, and opening times that fit around working hours. 

The best way to provide services for women who use drugs is to work with community representatives to find out what kind of support would be useful, and to train women who use (or used) drugs as peer educators to help deliver these services.

Opioid agonist therapy (OAT) involves taking opioid medication, such as methadone or buprenorphine. Methadone comes in a liquid form and buprenorphine tends to come in pill form. These medications act slowly, which means they prevent withdrawal and reduce cravings for opioid drugs like heroin. OAT medication works for around 24 hours, so people need to take it every day. 

Depending on the location you are in, people on OAT will either need to go to a doctor each day for OAT, or they may be able to get it from a pharmacist or another community location. In some places, once people have been on OAT for a while they may be given ‘take-home’ prescriptions that last for a month or more. Then they can manage their own doses and will only need to come back to the pharmacy or doctor for prescription refills.
 

OAT does not make a person feel high. This means people who are stable on OAT are often able to work or study, which is good for them and wider society. 

How long people need to be on OAT depends on the individual, but it is normally at least one or two years. Some people stay on it for much longer. Stopping OAT too early can lead to relapse and increases the risk of overdose.

It depends where you are. Some countries that criminalise drug use and drug possession still have national harm reduction programmes. Others are more cautious, but they do provide smaller-scale programmes as pilots to gather evidence on their effectiveness. 

You can find out the situation in your country by checking a report from Harm Reduction International called The Global State of Harm Reduction. 

Even if harm reduction services are allowed, funding is likely to be an issue. Gathering evidence on how many people use drugs there are and the services they need to reduce HIV infections can help make the case for investment. 

Remember that providing HIV prevention, testing and treatment services to people who use drugs is a type of harm reduction. This is not illegal anywhere and is something you can do to reduce the risk of HIV for people who use drugs, even if things like needle and syringe programmes are not possible.