It is estimated that 3.2 million women inject drugs worldwide, constituting around 20% of all people who inject drugs (notably, because of stigma, criminalisation, and lack of disaggregated data this is likely to be an underestimate). There are also indications that this number is increasing worldwide1 while women who use drugs remain population inadequately served with sexual and reproductive health (SRH) services.
Harm Reduction International and the Women and Harm Reduction International Network welcome the opportunity to report on to the Working Group on discrimination against women and girls on the enjoyment of sexual and reproductive health and rights by women who use drugs, who are indeed “in situations of crisis”.
Women who use drugs: a human rights and public health crisis The war on drugs is a war on people who use drugs. Women who use drugs are subject to daily crises as a result of drug prohibition, a policy clad in rhetoric around ‘well-being’ that in practice erodes public health, human rights and impacts women heavily. Under the banner of the war on drugs or drug prohibition, women who use drugs: face HIV and other health issues at a higher rate than their male counterparts,2 experience the arbitrary removal of children; are subject to coerced serialisation and contraception; are subject to much higher rates of gender-based violence than women in the general population; can be prosecuted and arrested for using drugs while pregnant; and, are incarcerated for non-violent crimes at alarmingly escalating rates. In some countries, women are disproportionately sentenced to death and executed for involvement with drugs.5 At the same time, there is an extreme lack of services designed to meet the SRH needs of women who use drugs.
Women who use drugs retain the full spectrum of health-related rights, including to harm reduction servicesand sexual and reproductive health rights (SRHR). 6 Yet, they face multiple and intersecting obstacles in realising such rights, because of a combination of: lack of available, accessible and acceptable services; legal barriers; stigma and discrimination – both in healthcare settings and in society; and, the lack of meaningful involvement of women who use drugs in the design, implementation, and evaluation of harm reduction and SRH services.