Making Harm Reduction Work for Women: The Ukrainian Experience

Ukraine‘s adult HIV prevalence is the highest of any country in Europe or Central Asia. According to the United Nations Development Programme, women now account for 48 percent of all HIV cases among adults in the country. Regional analysis suggests that this increase is largely attributable, either directly or indirectly, to injection drug use. UNAIDS estimates that 35 percent of women living with HIV in Eastern Europe and Central Asia acquired the virus through injection drug use, and a further 50 percent were infected through unsafe sex with partners who inject drugs.

Ukrainian programs have made great strides in responding to the HIV epidemic among injection drug users by introducing syringe exchange programs, methadone and buprenorphine treatment, anti-AIDS treatment, and programs to prevent mother-to-child transmission of HIV. Yet, these programs have rarely succeeded in fully accounting for the needs of women drug users.

In response to the existing gap in harm reduction services for women who use drugs, the Open Society International Harm Reduction Development Program, with the support of the Canadian International Development Agency, gave grants to six Ukrainian harm reduction organizations to implement gender-responsive services. Rather than developing new, separate programs for women, the grants were designed to build on the existing work of the organizations.

This report documents the experiences of the six programs, and offers recommendations for developing an effective system of care for women who use drugs.