Grant: Team Gr.: Embracing Diversity Achieve Prec./Health Equity-HIV/AIDS/STBBI-PHP-LOI

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 faced by WWUD and to better integrate them in research and prevention services. Our approach will take account of all the inequalities experienced by WWUD while examining overlapping structural vulnerabilities, 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 to enhance participation of WWUD in STBBI research, 2. to examine perceived vs. objective health needs among WWUD over time and associations with social and drug-related vulnerabilities, and 3. to estimate STBBI incidence and identify potential avenues of STBBI service adaptation according to perceived vs. objective needs. We will develop a portrait of WWUD participating or not in research projects, and co-construct new recruitment strategies with the help of people with lived experience and community workers. These strategies will be evaluated to establish best practices. We will combined quantitative (e.g., statistical analysis of answers to questionnaires) and qualitative methods (e.g., focus groups) to establish a cohort of WWUD. Participants will be followed with repeated questionnaire, STBBI and medical evaluation. Interpretation will contextualize the impacts of overlapping vulnerabilities on service use. People with lived experience are directly involved in this project and have contributed to defining the aims. This project will enable us to understand the realities of WWUD in all their dimensions, and thus better adapt services to their needs.