Case study : meeting the needs of women who use drugs in Malaysia

Injecting drug use is a major factor in HIV transmission. One third of HIV infections outside of sub-Saharan Africa are the result of injecting drugs, and women who use drugs, are a highly vulnerable and often hidden population.

Inequalities, gender norms and violence often place women who use drugs at high risk of HIV transmission while the intense stigma and discrimination they face can make accessing health services very difficult.

Where harm reduction services are available, too few specifically meet the needs of women.

The Alliance’s Community Action on Harm Reduction project (CAHR) is focused on improving the lives of drug users, their partners and families in five countries, including Malaysia. A fundamental part of this work is reaching women who use drugs and making sure harm reduction services meet their needs.

Identifying risk factors

The CAHR project is working with the Malaysian AIDS Council (MAC) and has carried out research to better ascertain the needs, risk factors and barriers to treatment faced by women who use drugs. This research will form the basis of a pilot project to address these issues.

The research, conducted by the Centre of Excellence for Research in AIDS at the University of Malaya, surveyed 104 women who use drugs in Kuala Lumpur. The majority were aged between 31 and 50 years, ethnically Malay, and had received some secondary school education. Almost two out of ten women engaged in sex work, and nearly all women interviewed had been detained in the past. Most were detained by the police. The main substances they reported using were methamphetamines, alcohol and heroin. A quarter of participants were on methadone.

The research showed that they were especially vulnerable to sexual violence and HIV. One in five women reported having been physically threatened, 27% had been sexually molested as a child and one in five had been forced to have sex. Reducing this vulnerability to sexual violence will be a key part of the pilot programme. The pilot programme will also look at improving the lives of women who use drugs through:

• Drug management services including methadone therapy
• HIV prevention and reducing the risks related to sex work
• Sexual and reproductive health services
• Care for children or women who use drugs
• Support for those living with HIV
• Income generation
• Advocacy support

You can read the full study here.

Community action on harm reduction

In each year of the project in Malaysia research will be carried out with key population groups and followed by a pilot programme. By 2014, the project will have reached 23,600 people who inject drugs which will equate to an increase in the national-wide annual coverage of this population by approximately 25%.

The CAHR project is funded by the Ministry of Foreign Affairs of the government of the Netherlands (BUZA).

You can read more about CAHR on the project’s website: www.cahrproject.org

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