Women who use drugs are collectively failed by India’s HIV response! This systemic neglect involves government departments, civil society and the private sector. While government programs have done well to address issues of women’s empowerment and increase their access to education, health and social entitlements more broadly, there are virtually no initiatives that address the various specific needs of women who use drugs.
Out of the 120 hospital-based de-addiction centres run by the Government of India’s Department of Health and Family Welfare and over 400 NGO-run centres through the Ministry of Social Justice and Empowerment, none are focused on issues of women, and most have little experience in supporting women who use drugs. A few private facilities cater to these needs, but they are expensive and out of reach for most women.
While the Department of AIDS Control is now funding Targeted Interventions for HIV prevention among these women, they are limited to the north-eastern part of the country. Besides this, interventions are primarily designed for male drug users, although some of which have been able to successfully reach their female partners with services.
Alliance India, along with NGOs like Sahara Aalhad, Voluntary Health Association of Meghalaya, SASO, Shalom and Dedicated Peoples Union to name a few, have demonstrated viable models of gender-responsive services for female drug using populations. Effective interventions include healthcare provided by female providers; counselling; referral to sexual & reproductive health services; harm reduction services (access to clean needles and syringes and Oral Substitution Therapy); detoxification and HIV-related care, diagnostics (blood tests required before and during antiretroviral therapy); prevention of parent to child transmission of HIV; safe spaces for women; and legal aid.
In our new film Out of the Shadows: Women Who Use Drugs in India activists and community members describe their challenges and their need for accessible, targeted, and quality harm reduction interventions to improve their health and protect their rights. Marginalized and unreached, these women are not well served by current interventions, and unsafe sexual behaviour and shared injecting equipment significantly increase their risk for HIV and hepatitis C infection. Exclusion, discrimination and violence further compound their vulnerability.
Women who use drugs need to emerge from the shadows, and programming in India can no longer afford to ignore them and the difficulties they face. There is a clear need for leadership and support to expand interventions for them by both government and civil society. We owe it to those women who are still in darkness and afraid to come out and live healthy and dignified lives.
The author of this post, Simon W. Beddoe, is Advocacy Officer: Drug Use & Harm Reduction, at India HIV/AIDS Alliance in New Delhi.
With funding from European Union, the Asia Action on Harm Reduction project supports advocacy to increase access by people who inject drugs (PWID) in India to comprehensive harm reduction services and reduce stigma, discrimination and abuse towards this vulnerable population through engagement with PWID and local partners in Bihar, Haryana, Uttarakhand, Delhi and Manipur.