Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka 1212, Bangladesh.
Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka 1212, Bangladesh.
Int J Drug Policy. 2021 Jun;92:103144. doi: 10.1016/j.drugpo.2021.103144. Epub 2021 Feb 3.
Women who inject drugs (WWID) experience various complexities, risks and vulnerabilities attributed to unequal gendered power differentials. This article has aimed to explore the unequal gendered power dynamics that influence HIV risks and vulnerabilities among WWID in Dhaka, Bangladesh.
This paper is based on an ethnographic study conducted from April 2018 to December 2019 in Dhaka, Bangladesh. This component of the study constituted 2500 h of extensive field observations, 15 in-depth interviews and five focus groups exclusively with WWID. We also interviewed 15 key-informants including programme managers, an academician and harm reduction service providers. Data were thematically analysed in relation to the four bases of gendered power theorised by gender scholars Pratto and Walker which include force, resource control, asymmetrical obligations and consensual ideologies.
The first base, "force", highlighted situations where WWID were compelled into risky injecting and sexual behaviours to avoid violent ramifications or losing their safety nets with intimate partners. The second base, "resource control", depicted unequal access to commodities where men exercised their dominance over money and drugs. The third base, "social obligations", depicted the propensity of WWID to obey their partners and clients, thus precipitating their risky behaviours. The fourth base, consensual ideologies, were linked to weakened negotiation powers of WWID, thus increasing their propensity to risky injecting and sexual behaviours alongside poly-drug use. Despite several instances of gender-based violence and oppression, WWID have fallen victim to gender-blind interventions, as demonstrated by study observations and anecdotes.
Gender-based violence and oppression were depicted as prominent driving forces exacerbating WWID's HIV risks and vulnerabilities. If these issues are overlooked, the HIV burden will continue permeating among WWID. Thus, stakeholders need to look beyond the lens of conventional harm reduction modalities and synergize evidence-based gendered dynamics to formulate a gender-responsive comprehensive service package for WWID.
注射吸毒女性（WWID）经历了各种复杂、风险和脆弱性，这些都归因于不平等的性别权力差异。本文旨在探讨影响孟加拉国达卡 WWID 感染艾滋病毒风险和脆弱性的不平等性别权力动态。
本文基于 2018 年 4 月至 2019 年 12 月在孟加拉国达卡进行的一项人种学研究。本研究部分包括对 WWID 进行了 2500 小时的广泛实地观察、15 次深入访谈和 5 次焦点小组访谈。我们还采访了包括项目管理人员、学者和减少伤害服务提供者在内的 15 名关键信息提供者。数据按照性别学者 Pratto 和 Walker 提出的性别权力的四个基础进行主题分析，这四个基础包括武力、资源控制、不对称义务和共识意识形态。
第一个基础“武力”强调了 WWID 为了避免暴力后果或失去与亲密伴侣的安全网而被迫进行危险注射和性行为的情况。第二个基础“资源控制”描绘了不平等获取商品的情况，男性在金钱和毒品方面占主导地位。第三个基础“社会义务”描述了 WWID 服从伴侣和客户的倾向，从而导致他们的危险行为。第四个基础“共识意识形态”与 WWID 谈判能力的削弱有关，从而增加了他们进行危险注射和性行为以及多药物使用的倾向。尽管存在一些性别暴力和压迫的情况，但 WWID 仍然是性别盲干预的受害者，这一点从研究观察和轶事可以看出。
性别暴力和压迫被描绘为加剧 WWID 感染艾滋病毒风险和脆弱性的突出驱动因素。如果这些问题被忽视，艾滋病毒负担将继续在 WWID 中蔓延。因此，利益相关者需要超越传统减少伤害模式的视角，协调基于证据的性别动态，为 WWID 制定一个有性别响应的综合服务包。
