What Works for Women and Girls

2. HIV prevention information and services are needed for IDUs receiving treatment forsubstance use. Studies found few IDUs are given condom negotiation skills or results oftheir HIV tests.Gap noted, for example, in Vietnam (Pham et al., 2008); and China (Cohen and Amon,2008).3. Interventions are needed to increase access to methadone and buprenorphine—effectivesubstitution therapy for the treatment of drug dependence. Studies found only tiny fractionsof those who need maintenance medication had access.Gap noted, for example, in Thailand, Indonesia, Bangladesh, Myanmar, India andNepal (Sharma et al., 2009); in Eastern Europe and Central Asia (Stuikyte et al., 2008);and generally (Piot et al., 2008, Mattick et al., 2003; Gowing et al., 2005 cited in IOM,2007).4. HIV prevention for IDUs must go beyond detoxification programs alone. Studies found thatwomen IDUs were not given reproductive health services, including PMTCT services, andhad low levels of condom use. Detoxification programs were substandard and ineffective.Gap noted, for example, Azerbaijan, Georgia, Kyrgystan, Russia and the Ukraine (OSI,2009); China (Sullivan and Wu, 2007: 121, Lui et al., 2006: 119); and generally (Gowanet al., 2008).5. Interventions are needed to inform women IDUs of harm reduction early in pregnancy.[See Chapter 9C-2. Safe Motherhood and Prevention of Vertical Transmission: Treatment]4C. Prevention for Key Affected Populations: WomenPrisoners and Female Partners of Male Prisoners“I do this because it is a goodthing to do. It helps preventinfections and saves lives.”—Prisoner/volunteer peer distributorof clean needles in Moldova(Hoover and Jurgens, 2009: 19)In many countries, women in prison, detention and rehabilitationcenters lack access to basic health and HIV/AIDSinformation and services, including treatment and care forwomen living with HIV. Interventions are clearly neededfor this population. A study in Sao Paolo, Brazil, foundhigh pregnancy rates among the female sexual partnersof young offenders in the prison system; demonstratingthe need for condom distribution and sexuality educationwithin prison systems (Yankah et al., 2006). A study foundhigh rates of HIV among prison inmates in low- and middle-income countries. HIV prevalencewas greater than 10% in prisons in 20 countries: Brazil, Burkina Faso, Cameroon, Côte100 CHAPTER 4 PREVENTION FOR KEY AFFECTED POPULATIONS