The main objective of contraception for WUD is - as it is for all other women- to avoid unwanted pregnancies and prevent abortion.
The main objective of contraception for WUD is - as it is for all other women- to avoid unwanted pregnancies and prevent abortion. It is important that WUD are in the condition to choose the type of contraception they feel more comfortable with and are able to manage the way in which it is administered.
Gender-specific HR services should therefore make sure that the different needs for contraception are met and support their clients with appropriate information. Contraceptives should be made available in low threshold settings free of charge, since their cost might be a great barrier for WUD.
WUD need to be made aware that no other contraceptive apart from condoms protects them against sexually transmitted infections. Male and female condoms should therefore be highly recommended, especially in those cases in which WUD engage in sex work. For those women who do not envisage the need to use condoms as a mean of protection from STIs (they have a steady sexual partner, may be allergic to latex, etc.), other contraceptives should be made available in order to prevent unwanted pregnancies.
Rather than punishing women for their drug use, health programmes that aim to reduce barriers to obtaining free, non-discriminating reproductive advice and parenting assistance would better utilise women’s own capacity to improve their reproductive health. Therefore, it is important that staff is trained to discuss the following issues related to contraception during counselling sessions offered in gender- specific services:
chances of serious side effects like thrombosis when taking oral contraceptives;
medical contraindications of some contraceptives in case of smoking, high blood; pressure, overweight,
thrombosis in immediate family;
the range of available contraceptives;
benefits/availability of long-term contraceptives;
visible vs invisible contraceptives;
medications that might reduce or eliminate the effect of contraceptives;
availability of / access to contraceptives; and
emergency contraception (a tablet that must be taken as quickly as possible and within 72 hours after unprotected intercourse or condom breakage).
When WUD find out they are pregnant and they do not want to have a child, abortion services should be available free of coercion and offered in a respectful and non-judgmental manner. Health workers offering abortion, as itshould be with all health workers, must respect the rights of WUD, especially when they are living with HIV, by providing access to abortion if desired and by ensuring that women make the choice for themselves. If only one type of abortion (medical or surgical) is offered in a specific setting, WUD should have access to that option. Limited options for all women should not result in barriers to access for WUD.
