Dr Emily Rowe is an Asia based health anthropologist and harm reductionist whose body of work focuses on intersectionality, sex work, SOGIESC and gender. They are currently engaged as the Programmes and Strategy Lead at Women and Harm Reduction International Network.

While tools exist to enable harm reduction services to institute a gender lens and gender responsive approach, data on the application of such measures is scarce. To address this, WHRIN undertook a participatory global ‘mapping’ of gender responsive harm reduction services. 2024 findings indicated that there is a paucity of services by/for women and gender diverse people who use drugs. Pervasive intersections between prohibition and patriarchy act as a key barrier while most responses demonstrated an overwhelming overemphasis on ‘rehabilitation’ or ‘recovery’ service modalities. Services for communities such as sex workers who use drugs continue to fall under the rubric of HIV prevention, thus failing to address broader harm reduction needs. There is a lack of services for viral hepatitis prevention, testing and treatment, gender-based violence and sexual and reproductive health services for women and gender diverse people who use drugs. In global majority countries, services for women and gender diverse people who use drugs are not common but, where they exist, demonstrate in some cases that state of the art services are viable in challenging contexts. There is a need for decision makers to address discrimination and stigma, and to decriminalise and decarcerate women and gender diverse people who use drugs and provide opportunity for communities to lead in service programming and delivery. Many respondents evidently remain unclear about the need for and the markers of gender responsive harm reduction, indicating the importance of on-going capacity building across the sector. Further it behoves providers to develop and implement peer-led women specific harm reduction services that are safe and non-judgemental spaces, for women and gender diverse people who use drugs including those with children and those incarcerated/recently released or those at risk of/experiencing violence.