Eurasian Harm Reduction Association (EHRA), Verkiu St. 34b, 7 Fl., LT-09108, Vilnius, Lithuania.
Canadian HIV/AIDS Legal Network, 40 Bay Street, Suite 600, Toronto, Ontario, M5R 2A7, Canada.
Harm Reduct J. 2018 Nov 6;15(1):54. doi: 10.1186/s12954-018-0259-1.
Estonia continues to have the highest prevalence of HIV among people who inject drugs, and the highest overdose mortality, in the European Union. In August 2017, the Eurasian Harm Reduction Association (EHRA), the Canadian HIV/AIDS Legal Network (CHALN), and the Estonian Association of People Who Use Psychotropic Substances (LUNEST) conducted a study in Estonia to assess the situation regarding the human rights of women who use drugs and/or living with HIV.
The research methodology, developed by EHRA and CHALN, comprised in-depth interviews with 38 drug-dependent women conducted between August 8 and 14, 2017, in Tallinn and Ida-Viru county. The interviews were transcribed, and 37 were analyzed using thematic content analysis.
The study has documented widespread violations of parental rights (removal of children because of their mother's inability to cease drug use and barriers to regaining custody), violations of the right to health (the failure to provide quality drug and HIV treatment, and the disclosure of medical data, including HIV status and opioid substitution treatment (OST) records), the violation of labor rights due to drug use, arbitrary arrest, street drug testing, and violations of the right to a fair trial. A number of women have experienced repeated cases of gender-based violence but have had no access to psychosocial support, shelters, or other protection or rehabilitation measures.
Our findings suggest that punitive drug laws and their enforcement practices, the lack of gender-specific drug treatment facilities, combined with stigma related to drugs and HIV, are the main drivers of systematic and serious violations of the human rights of women who use drugs or who are drug dependent. Stigma and human rights violations undermine Estonia's efforts in HIV prevention, care, and treatment, and its overall efforts to respect, protect, and fulfill the right to health of women who use drugs or who are drug dependent. For these reasons, the Government of Estonia should address a variety of issues related to the protection of human rights of this vulnerable population group.
在欧盟中，爱沙尼亚的艾滋病毒流行率在注射毒品者中仍居首位，药物过量死亡率也最高。2017 年 8 月，欧亚减少伤害协会（EHRA）、加拿大艾滋病毒/艾滋病法律网络（CHALN）和爱沙尼亚使用精神药物者协会（LUNEST）在爱沙尼亚进行了一项研究，评估了女性吸毒者和/或艾滋病毒感染者的人权状况。
EHRA 和 CHALN 制定的研究方法包括 2017 年 8 月 8 日至 14 日在塔林和 Ida-Viru 县对 38 名吸毒女性进行的深入访谈。访谈内容被转录，其中 37 份内容使用主题内容分析进行了分析。
该研究记录了广泛侵犯父母权利的行为（因母亲无法停止吸毒而剥夺子女抚养权以及重新获得监护权的障碍）、侵犯健康权的行为（未能提供优质的毒品和艾滋病毒治疗以及泄露医疗数据，包括艾滋病毒状况和阿片类药物替代治疗记录）、因吸毒而侵犯劳动权利、任意逮捕、街头毒品检测以及侵犯公平审判权的行为。一些女性曾多次遭受性别暴力，但无法获得社会心理支持、庇护所或其他保护或康复措施。
我们的研究结果表明，惩罚性毒品法及其执法做法、缺乏针对特定性别的毒品治疗设施，加上与毒品和艾滋病毒相关的耻辱感，是系统和严重侵犯吸毒或依赖毒品女性人权的主要驱动因素。耻辱感和侵犯人权行为破坏了爱沙尼亚在艾滋病毒预防、护理和治疗方面的努力，以及其尊重、保护和实现吸毒或依赖毒品女性健康权的整体努力。出于这些原因，爱沙尼亚政府应解决与保护这一弱势群体人权相关的各种问题。
