Grant: Team Grant:Embr. Diversity to Achieve Precision/Health Equity-HIV/AIDS/STBBI-PHP

The overlap between gender and drug use makes women who use drugs (WWUD) particularly vulnerable to experiencing sexism, intimate partner violence, stigma, and parental challenges, among other gender-related problems. Yet the distinct needs of WWUD remain almost invisible in sexually transmitted and blood-borne infections (STBBI) research and care delivery. We aim to improve understanding of the specific vulnerabilities, strengths, and capacities of WWUD and to better integrate them in research and prevention services. Our approach will take account of social and structural vulnerability experienced by WWUD while examining health-related behaviors, use of STBBI and broader health services, as well as adequacy of services in meeting their specific needs. The objectives are: 1.to develop best practices in engaging WWUD in STBBI research, 2. to document the social and structural vulnerability that shape WWUD's STBBI- and other health-related outcomes, and 3. to examine access to STBBI services and identify potential avenues for adaptation in line with the strengths, capacities and preferences of WWUD. Our project combine participatory, quantitative (e.g., statistical analysis of answers to questionnaires) and qualitative methods (e.g., interviews). People with lived/living experience of drug use have been involve in the project since the beginning and will play a key role in the project, especially for the development of best practices to engage women in research. We will establish a cohort of WWUD. Participants will be followed with repeated questionnaire, STBBI and medical evaluation. Interpretation will contextualize the impacts of vulnerabilities on service use. This project will enable us to understand the realities of WWUD in all their dimensions, and thus better adapt services to their needs.