女性与减少伤害服务障碍：来自西班牙巴塞罗那定性研究的文献综述和初步发现。
Women and barriers to harm reduction services: a literature review and initial findings from a qualitative study in Barcelona, Spain.
机构信息
Harm Reduction International, 61 Mansell Street, London, E1 8AN, UK.
Metzineres. Environments of Shelter for Womxn Who Use Drugs Surviving Violence, c/o ICEERS, Carrer de Sepúlveda, 65, Oficina 2, 08015, Barcelona, Spain.
出版信息
Harm Reduct J. 2020 Oct 19;17(1):78. doi: 10.1186/s12954-020-00429-5.
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 are available suggest 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; and 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.
背景
全球估计有 320 万女性注射毒品，占所有注射毒品者的 20%。现有有限的数据表明，与男性注射毒品者相比，女性注射毒品者感染艾滋病毒和病毒性肝炎的风险更高。这种脆弱性的增加是一系列影响女性的环境、社会和个人因素的产物，这些因素也影响了她们参与促进健康服务的能力，如减少伤害。
方法
研究人员进行了叙述性文献综述，审查了欧洲女性注射毒品者获得减少伤害服务的情况，并在西班牙巴塞罗那与女性注射毒品者以及减少伤害和监狱卫生工作者进行了半结构化焦点小组讨论。
结果
女性注射毒品者在获得减少伤害服务方面面临多种障碍。这些障碍包括污名化，既包括整个社会的污名化，也包括监狱和社区中卫生和减少伤害工作者的污名化；性别暴力以及缺乏能够解决吸毒和暴力经历相互作用的服务；刑事化，表现在法律障碍、执法部门的逮捕和骚扰以及监禁；以及缺乏关注女性特定需求的服务，特别是性和生殖健康服务和儿童保育。在巴塞罗那，参与者报告说经历了所有这些障碍，他们与 Metzineres 减少伤害中心的接触在一定程度上减轻了这些障碍。然而，女性仍然面临着获得减少伤害服务的结构性障碍。
结论
女性和跨性别注射毒品者在获得减少伤害服务方面面临独特的障碍。虽然 Metzineres 等服务对其成员来说可能是改变生活和肯定生活的，但各国必须采取行动，解决女性注射毒品者面临的结构性健康障碍。
Zotero 插件