What Works for Women and Girls

than were naltrexone or placebo. HIV risk behaviors were significantly reduced frombaseline across all three treatments due to counseling. No sex disaggregated data wasprovided. Prior to randomization, all patients completed a 14-day detoxification protocolin a residential setting, during which they were given buprenorphine and naltrexone,along with medication as needed for withdrawal symptoms. Nurses received four daysof training and provided individual counseling sessions of 45 minutes (Schoettenfeld etal., 2008). (Gray I) (drug use, drug treatment, IDU, Malaysia)A Cochrane review with 33 studies involving 10,400 participants found that “studiesconsistently show that oral substitution treatment for opiod-dependent injecting drugusers with methadone or buprenorphine is associated with statistically significantreductions in illicit opiod use, injecting drug use and sharing of injecting equipment.It is also associated with reductions in the proportion of injecting drug users reportingmultiple sex partners or exchanges of sex for drugs or money” (Gowing et al., 2008:2). These reductions in risk behaviors related to drug use result in lower rates of HIV(Gowan et al., 2008). (Gray III). A sufficiently high dose of methadone (more than 60mg per day is required and programs need to allow for sufficiently long treatment durationi.e. at least more than six months if concomitant drug use is to be reduced (Jurgenset al., 2009b). (Gray III) (drug use, drug treatment, opiods, sexual partners, IDU)A 2009 review of international implementation of opiod substitution found that opiodsubstitution treatment is the most effective treatment available for heroin dependence,resulting in reduced heroin use, HIV transmission and mortality (Larney and Dolan,2009). (Gray III) (opoids, drug treatment)A retrospective review in the United States of 81 mothers who received methadone andtheir 81 offspring found that a higher dose (mean of 132 mg compared to the lowermean of 62 mg) had a positive effect on maternal drug use with no increased risk ofneonatal abstinence symptoms (McCarthy et al., 2005). (Gray III) (drug treatment, pregnancy,United States)A review of literature on methadone use for pregnant addicts in the United States,Europe, and Australia from 1995 to 2000 found that it is key to provide a sufficient methadonedose to pregnant women so as to reduce illicit drug supplementation (Beusekomand Iguchi, 2006). (Gray IV) (drug treatment, pregnancy, United States, Europe, Australia)A methadone maintenance therapy resulted in decreased HIV prevalence in an IDUpopulation in Iran from March 2003 to March 2007 from 3.39% to 2.99%, basedon annual sero-surveillance data from 400 sentinel surveillance sites, using samplescollected from about 100 sites each year, with 25% of samples collected from IDU criminals.Methadone maintenance coverage increased from 300 to 8,048 prisoners duringthis time (Yasaghi et al., 2008). No sex disaggregated data was given, but according tothe UK Prison Center, 3.7% of Iranian prisoners are women. According to UNDOC,9.4% of the more than 1,200,000 IDUs in Iran are women. (Gray III) (drug use, drugtreatment, prisoners, IDU, Iran)WHAT WORKS FOR WOMEN AND GIRLS93