Access to Harm Reduction Services among Women who Use Drugs Living near the Armed Conflict Zone in Ukraine

Daria Matyushina-Ocheret, Svetlana Moroz

Background: The armed conflict in the East Ukraine, which started in 2014 after the Russian annexation of Crimea, has negative impact on the access of women who use drugs (WUD) to harm reduction and opioid substitution therapy (OST). While OST is not currently available in annexed and conflict zone territories of Ukraine, harm reduction services and OST in the area at the border of the armed conflict are provided but their quality and accessibility is unknown. WUD are in general more vulnerable to harm reduction service interruption, face greater barriers to social services and are more vulnerable to violence than men. No empirical research on the WUD access to harm reduction services has been carried out in East Ukraine so far.

Methodology: In 2018 a community-based women-led research was organized to explore access and barriers to harm reduction services among WUD living near the armed conflict zone in Ukraine. The study uses mixed methods (in-depth interviews and questionnaire-based survey) and smallball sampling. Special safety protocol was developed to protect research participants given high spread of violence and kidnapping in East Ukraine.

Results: Most of participants, including those living with HIV and HCV, reported unemployment, unstable housing and having not enough money to buy food. Lack of access to OST in the armed conflict territory and personal security concerns were driving factors for WUD migration/displacement. Harm reduction services were hardly accessible. OST interruptions occurred in the last years. The majority of women faced drug dependence status disclosure by medical staff and police, and violence. Women reported neither protection by the police nor shelters availability.

Conclusion: The study fills in the gap in information on WUD access to harm reduction services, vulnerability to violence and trends in the socio-economic status as the result of the armed conflict in East Ukraine.