Table 1.
Research Gaps on HIV in Women who Use Drugs
| Research Questions | Study needed |
|---|---|
| Epidemiology | |
| How prevalent is drug use among women in low and middle income countries? | Sex-disaggregated statistics in country-level studies as well as global surveillance systems on all different drugs including prescribed painkillers |
| How prevalent is drug use among certain sub-populations of women? | Population-based studies of WSW, transgender women, incarcerated women, sex workers, adolescents and girls |
| How prevalent is HIV in women who use drugs? | Epidemiological studies globally, but primarily in middle and low- income countries, with sex-disaggregated data |
| How prevalent are co-occurring disorders such as HIV, violence, etc. among women who use drugs? | Population-based and epidemiological studies of SAVA syndemic (Substance Use, Violence, and AIDS factors and other co- occurring disorders |
| How prevalent is HIV among drug- using women in the criminal justice system? | Epidemiological studies that take place among groups of incarcerated women and women in alternative to incarceration programs. |
| How prevalent is HIV among non- injection drug users? | Epidemiological studies of HIV prevalence among women and girls who use, but don’t inject, drugs and alcohol. |
| Basic Research | |
| What forms of vaginal and rectal microbicides will be acceptable, safe and effective for women who use drugs? | Inclusion of women who use drugs in phase 1 and phase 2 trials of microbicides |
| What forms of oral or injectable PreP will be acceptable, safe and effective for women who use drugs? | Inclusion of women who use drugs in phase 1 and phase 2 trials of PreP |
| HIV Prevention | |
| What interventions will reduce HIV incidence for women who use drugs and have co-occurring disorders such as violence, etc.? | Population-based studies of SAVA syndemic factors and other co- occurring disorders |
| Improvement of care | |
| How well do harm reduction and drug treatment services reach women? | Sex-disaggregated surveillance data on harm reduction and drug treatment services |
| How to maximize effectiveness of interventions for women? | Interventions studies (all stages) for women, especially in biomedical research. |
| Structural change | |
| What is the effect of decriminalization of drug use and sex work? | Population-based longitudinal or comparative studies that examine effects of decriminalization on access to harm reduction. Some research, including theoretical modelling studies exist, but because these behaviors are criminalized in most countries worldwide, not many research opportunities exist. |
| How might police education programs reduce HIV risks among women who use drugs? | Longitudinal studies to examine the impact of police education programs on HIV risk behaviors of women who use drugs, including sex workers. |
| How do the institutions of race, ethnicity, and class interact with gender to heighten risk among drug-using women? | Consideration of intersectionality in formative research and mathematical models with PWID, disaggregated by sex. Studies should include a diverse sample of drug-using women. |