The Global State of Harm Reduction in Prisons

Sander, Gen; Shirley-Beavan, Sam; Stone, Katie

doi:10.1177/1078345819837909

Cited by 54 publications

(62 citation statements)

References 38 publications

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“…[17] Access to harm reduction in prisons is severely limited worldwide, and there is a grave dearth of data on prisoner health. [73,74] HIV, viral hepatitis and tuberculosis treatment and prevention, including NSPs and OAT, are near universally less accessible in prison that outside. [13,74] As a result, incarceration represents a signi cant risk factor for blood-borne virus transmission associated with injecting drugs.…”

Section: Criminalisationmentioning

confidence: 99%

“…[73,74] HIV, viral hepatitis and tuberculosis treatment and prevention, including NSPs and OAT, are near universally less accessible in prison that outside. [13,74] As a result, incarceration represents a signi cant risk factor for blood-borne virus transmission associated with injecting drugs. [68,74] Despite the growing population of incarcerated women, antiretroviral therapy for HIV treatment, NSPs and OAT are all more widely available in male prisons than in female prisons.…”

Section: Criminalisationmentioning

confidence: 99%

“…[13,74] As a result, incarceration represents a signi cant risk factor for blood-borne virus transmission associated with injecting drugs. [68,74] Despite the growing population of incarcerated women, antiretroviral therapy for HIV treatment, NSPs and OAT are all more widely available in male prisons than in female prisons. [68,74] Men are consistently prioritised for prison health services, due to the larger number of men incarcerated and therefore the greater urgency and cost-effectiveness of providing services to male prisoners.…”

Section: Criminalisationmentioning

confidence: 99%

“…[68,74] Despite the growing population of incarcerated women, antiretroviral therapy for HIV treatment, NSPs and OAT are all more widely available in male prisons than in female prisons. [68,74] Men are consistently prioritised for prison health services, due to the larger number of men incarcerated and therefore the greater urgency and cost-effectiveness of providing services to male prisoners. [75][76][77] Women consistently report unsafe injection behaviour in prison in the absence of accessible sterile injecting equipment.…”

Section: Criminalisationmentioning

confidence: 99%

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Women and Barriers to Harm Reduction Services: A Literature Review and Initial Findings From a Qualitative Study in Barcelona, Spain

Shirley-Beavan

Forteza²,

Burke-Shyne

et al. 2020

Preprint

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Background There are an estimated 3.2 million women who inject drugs worldwide, constituting 20% of all people who inject drugs. The limited data that is available suggests that women who inject drugs are at greater risk of HIV and viral hepatitis acquisition than men who inject drugs. This increased vulnerability is a product of a range of environmental, social and individual factors affecting women, which also affect their ability to engage in health promoting services such as harm reduction. Methods The researchers undertook a narrative literature review examining access to harm reduction services for women who use drugs in Europe, and conducted semi-structured focus groups with women who use drugs and harm reduction and prison health workers in Barcelona, Spain. Results Women who use drugs face multiple barriers to accessing harm reduction services. These include: stigma, both in society in general and from health and harm reduction workers in prisons and in the community; gender-based violence and a lack of services that are equipped to address the interaction between drug use and experiences of violence; criminalisation in the form of legal barriers to access, arrest and harassment from law enforcement, and incarceration; a lack of services focused on the specific needs of women, notably sexual and reproductive health services and childcare. In Barcelona, participants reported experiencing all these barriers, and that their engagement with the Metzineres harm reduction centre had to some extent mitigated them. However, women continued to experience structural barriers to harm reduction service access. Conclusions Women and gender non-conforming people who use drugs face unique barriers to accessing harm reduction services. While services such as Metzineres can be life-changing and life-affirming for its members, it is incumbent on states to act to address the structural barriers to health faced by women who use drugs.

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Section: Criminalisationmentioning

confidence: 99%

Section: Criminalisationmentioning

confidence: 99%

Section: Criminalisationmentioning

confidence: 99%

Section: Criminalisationmentioning

confidence: 99%

See 2 more Smart Citations

Women and Barriers to Harm Reduction Services: A Literature Review and Initial Findings From a Qualitative Study in Barcelona, Spain

Shirley-Beavan

Forteza²,

Burke-Shyne

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Other reasons for low uptake of treatment by women include hostile attitudes of medical staff or clinics being inundated with male clients, making them uninviting for female clients. incb, 2016, 7 Women also face greater barriers to accessing harm reduction services and treatment in prison (Sander, Shirley-Beavan and Stone, 2019) and in the community. This is not exclusive to Latin America but can be defined as a global problem, with different countries providing different levels and quality of access (Ayon et al, 2019;Médecins du Monde, 2019;Uusküla et al, 2018); furthermore, women who use drugs and are victims of violence are usually denied access to shelters for women victims of violence based on their drug use, either by law or by institutionalised practice, thus leaving them and their children in a situation of further vulnerability due to the actions of state and private institutions (Benoit and Jauffret-Roustide, 2016;hri, 2013).…”

Section: 2mentioning

confidence: 99%

The Gendered Impacts of Drug Policy on Women: Case Studies from Mexico

Giacomello

2020

Drug Policies and Development

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This chapter looks at women involved in drug offences and women who use drugs, from the perspective of the intersection of three axes: i) gender relationships and gender systems, ii) development, and iii) drug policy. Its purpose is to analyse the impacts of drug policy on women from a gender perspective, with a focus on two groups of 'women in detention': incarcerated women and women in residential treatment centres. The paper argues that current drug policies are part and parcel of patriarchal structures that underlie violence against women and children and undermine gender equality and development. The international framework of drug control generates, via prohibition, illicit drug markets and drug trafficking organisations, which mirror hegemonic gender systems and treat women and children as disposable objects, maintaining sexist structures that lead to the exploitation of women's labour by their male partners, patriarchal relations with regard to illicit waged labour, and patriarchal violence and culture. The other direct results of the implementation of international drug policy are the use of incarceration as a means of deterrence and the growing number of women in prison for drug offences. Also in the case of women who use drugs, current drug policies contribute, with practical and discursive elements, to the reproduction and justification of violence against women and girls. The two groups of women in detention analysed in this chapter, instead of being accompanied by communities, families and state institutions that address and attempt to repair the suffering and the crimes committed against them, are further isolated through institutionalisation in legal or illegal sites, in which violence against women is further reproduced and development is hindered.

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The Impact of COVID-19 on Drug Use and Harm Reduction Programming in the Middle East and North Africa (MENA) Region: a Regional Consultation of Stakeholders and People Who Use Drugs

Hout

Haddad²,

Aaraj³

2021

Int J Ment Health Addiction

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The Middle East and North Africa (MENA) region has witnessed a slow but steady increase in the harm reduction response since 2016. It is likely that such gains are threatened by the impact of COVID-19. Very little is known about the health response and situation of people who use drugs (PWUD) during the pandemic in the region. A mixed method study was conducted by the MENA Harm Reduction Association (MENAHRA) to assess the situation of PWUD and impacts on harm reduction services during COVID-19. Twelve countries and two regional viewpoints responded to the survey. A virtual focus group was held with the MENA Network of People who Use Drugs (MENANPUD) focal points (n = 11). The study highlights how COVID-19 aggravated existing marginalization and stigmatization of PWUD and other key populations in the MENA region, with government level resourcing severely impacted by COVID-19. It further illustrates the commitment by harm reduction non-governmental organizations (NGOs) in diversifying their response, particularly through mobile outreach to drug hot spots, and the reliance of technology to support awareness raising, telemedicine, and medicine supplies. Positive shifts are observed in harm reduction policy by governments in some MENA countries and the continued commitment to support PWUD communities by existing harm reduction NGOs. Continued advocacy for and implementation of harm reduction responses at the domestic and regional levels should be underpinned by inclusion in state health emergency planning and disease control efforts, awareness raising around innovation and telemedicine to support health and NGO support systems and medicine supply chains, resourcing of NGOs, and provision of economic support for PWUD, disease surveillance, and research.

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The Global State of Harm Reduction in Prisons

Cited by 54 publications

References 38 publications

Women and Barriers to Harm Reduction Services: A Literature Review and Initial Findings From a Qualitative Study in Barcelona, Spain

Women and Barriers to Harm Reduction Services: A Literature Review and Initial Findings From a Qualitative Study in Barcelona, Spain

The Gendered Impacts of Drug Policy on Women: Case Studies from Mexico

The Impact of COVID-19 on Drug Use and Harm Reduction Programming in the Middle East and North Africa (MENA) Region: a Regional Consultation of Stakeholders and People Who Use Drugs

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