Violence agains women who use drugs

Violence against women is endemic worldwide and, despite all the human rights efforts, campaigns and interventions at all levels, it seems to have no easy solution. Some specific groups of women are particularly vulnerable to it, yet their needs are continually ignored. This becomes evident when addressing violence against WUD. WUD are the victims of many different layers of violence. They even suffer structural violence deriving from punitive drug enforcement, which increases harms associated with drug use.

Despite their vulnerability to the many forms of violence and abuse, the majority of WUD are not allowed to access shelters. The failure to ensure access to shelter and specific support to WUD is caused by various structural inequalities from the denial of access by shelter managers to state policies that intentionally ignore the needs of WUD. HR service providers should establish strong relationships with women’s shelters and ancillary social services to ensure that WUD have access to the support they need and receive non-judgmental services.

There is evidence that intimate partner violence is also more commonly experienced by WUD than women in the general population. Many WUD experience violence and abuse within the relationship with their partners. The low social status of many among these vulnerable women increases such risk. Over 80% of WUD have been abused in their homes.

Violence against women can both lead to substance use and contribute to the development of patterns of problematic drug use. The European Monitoring Center for Drugs and Drug Addiction (EMCDDA) reports that problematic drug use can lead to women engaging in sex work as a source of income, and sex work can increase their vulnerability to violence.

It is widely acknowledged that women victims of violence need specialized services, but in many countries social services or general shelters are not organized to support women who experience violence. Furthermore, shelters lack the specialized services that are necessary for specific health problems.

It is recommended to provide counselling sessions for women’s partners to reduce violent reactions when at home. Partners might be included in post-test counselling sessions. Partner notification can be conducted in the counsellor’s office and role playing can help prepare the client to test result notification.

GENDER BASED VIOLENCE

WUD are highly vulnerable to gender-based violence, i.e. physical, mental, emotional and other forms of abuse and harassment directed towards women. HR programs and other HIV-related services can address GBV by providing direct support or referral to specialized organizations. Sometimes extra measures and means of protection may be required to enable WUD to report abuse. In order to address GBV, gender-specific services need to:

• ensure that WUD are aware of their rights and informed about where and how to report on police misconduct;
• provide survivors of sexual assault with, or offer accompaniment to, clinical care for post-exposure prophylaxis (PEP) and emergency contraception;
• offer STI services and psychosocial support;
• support the development of violence prevention sessions specifically tailored towards WUD.

VIOLENCE BY LAW ENFORCEMENT AGENCIES

When WUD are HIV positive and engage in sex work, discrimination and violence double and they become more vulnerable to violence by the police. In countries where drug use and sex work are criminalized, there is limited access to legal aid and basic health care and WUD are left powerless and unprotected at the hands of police.

Evidence indicates that WUD in the EECA region are the victims of police violence and of physical, emotional and sexual violence during and/or after detention. Human rights violations, including ill treatment and torture, are commonly used to get confessions or false testimonies. There is solid evidence of unjustified detentions, refusal of right to a lawyer and violation of personal security for WUD.

Police violence affects WUD in many ways, including serious and often life-threatening physical and psychological health problems. It increases stigma and discrimination against women and barriers to access health services, which contribute to the HIV epidemic. It also discredits police as an institution and contributes to expanding gender inequality and social injustice.