Theme: Social Science & Policy Research Year: 2024
Background and objectives: In France as in Canada, women drug users represent on average a quarter of active queues in harm reduction structures, even though drug use has become more prevalent for women in the Western world since the 1990s. Socially included people are also less numerous in harm reduction structures in both countries. This communication aims to understand this reduced recourse to care for socially included women who use drugs, and to highlight perspectives for improving harm reduction among this population.
Methods: The results presented, from a thesis in sociology, are based on 97 interviews carried out with drug users who do not have recourse to care, socio-health professionals, and actors and experts in drug-related policies, in Bordeaux and Montreal.
Results: In both cities, harm reduction structures are mainly designed to meet the needs of a male and precarious public, despite very different public health models. However, some structures are targeting more diverse profiles, but the users interviewed do not request them either, for four main reasons: they have already felt judged by health professionals because of their drug uses, they are unaware of existing structures, they feel they do not need help, and they do not identify with the marginalized public that they associate with care structures.
Conclusions: To reach a hidden population and improve harm reduction among this female and integrated public, it seems necessary to train front-line health professionals, recruit peer helpers, and invest more in digital and festive spaces. It also appears essential to rethink gender in public health, anchoring ourselves in a gender-transformative health perspective. This can notably involve the establishment of single-sex times in harm reduction structures.