Taking into account specificity of issues as well as importance of early diagnostic and treatment of women who use drugs, it is strongly recommended to review existing harm reduction services for gender sensitivity and involve WUD on every stage of this work – from identifying the gaps, to designing new offers. Harm Reduction International developed lists which draw on examples of existing gender-specific HR services and provide a ‘menu’ of options to improve and expand care for WUD. Since HR strategies and programs are implemented very differently (and sometimes not at all implemented) in the different countries, ideally services should be tailored to the needs of women in a given context. In order to be cost effective and achieve maximum result, it is important to provide all recommended HR core interventions as a comprehensive package – rapid HIV/HCV testing must be offered together with other harm reduction services, including needle and syringe provision, OST, linkage to treatment, information and consultation. The following improvements have been suggested for those organizations that can only afford to bring adjustments or small additions to their existing services/programs:
A «children play corner», including table, chairs and some toys was put in some NGOs in Hungary and Lithuania during the HA-REACT project. The cost of the intervention was 0 Euro, but it definitely improved impression of WUD towards the services. For those organizations, which can invest some funds for improving their services, it is recommended to add the following:
Finally, it is important to keep in mind that the components of an enabling environment that need to be addressed across the individual, relationship, community and societal levels to support SRHR for WUD should always include the following:
Low threshold settings, offering rapid HIV and HCV testing for WUD must ensure qualitative pre- and post-test counseling and linkage to care, including accompanying of women for the confirmatory tests and treatment.