TOOLKIT FOR UNDERSTANDING INTEGRATED SRHR SERVICES FOR FEMALE SEX WORKERS WHO USE AND INJECT DRUGS

Below is its explanation on the website page..

“Globally, Female Sex Workers Who Use and Inject Drugs (FSWWUIDs) face barriers in accessing and utilizing SRHR services. Some of these barriers include higher levels of stigma and discrimination, family/community rejection, GBV, economic hardships, judgmental attitudes/misinformation from service providers (regarding their ability/suitability to have/raise their own children) and the unfavourable legal/policy environment. These barriers impact access to contraceptives, appropriate ante- and post-natal care; HIV/STI services (prevention, care, treatment, and psychosocial support services), SGBV prevention services, cancer screening/management services, infertility/abortion services and accurate information. FSWWUIDs have greater vulnerability than men to HIV, HCV, STIs and other blood borne; and are less enabled to access and adhere to ART than their male counterparts. Some of them experience forced/coerced sterilisation or abortion and have had their children takenaway and placed under foster/caregiver care.

The limitations in access to SRHR services as described above further leads to other challenges such as high rates of unintended pregnancies, high rates of unintended pregnancy and abortion. This could be summed up to mean that FSWWUIDs are not accessing and utilising essential and comprehensive SRHR services as have been provided for in guidelines and human rights instruments as fundamental health rights. The challenging condition is made worse by the fact that most FSWWUIDs neither know nor can demand for their SRH rights.

Supported by UHAI, the Alliance of Women Advocating for Change (AWAC) developed this toolkit for three reasons i.e.,

(i) help service beneficiaries to understand integrated SRHR services and empower them to challenge stigma and discrimination associated with access to services at health facility and/or community level;

(ii) guide those who provide services to FSWWUIDs including drop-in centres and harm reduction services on the importance of integrated SRHR services and

(iii) provide recommendations on SRHR service integration for FSWWUIDs.

The health system should have effective and efficient mechanisms for;

(i) Detection, prevention and treatment of HIV and other STIs (including reproductive tract infections);

(ii) Detection, prevention and management of reproductive cancers;

(iii) Detection, prevention and management of sexual and gender-based violence;

(iv) Prevention, management and treatment of infertility;

(v) Safe and effective abortion services and treatment of unsafe abortion;

(vi) Counselling and services for modern contraceptives with focus on choice;

(vii) Safe and effective antenatal, childbirth and postnatal care;

(viii) sharing information, counselling and services for sexual health and wellbeing; and

(ix) sharing accurate information and counselling on sexual and reproductive health, including evidence-based Comprehensive Sexuality and education (CSE).

Integration does not mean that all sexual and reproductive-health or other services must be provided on site, but it does require that health-care providers have the knowledge and skills to provide an appropriate basic package of services and to refer patients for other necessary services that are not provided at that site.
Sexual and Reproductive Health Rights for FSWWUIDs are not unique but are similar to those of all individuals and include:

(i) have their bodily integrity, privacy and personal autonomy respected;

(ii) freely define their own sexuality, including sexual orientation and gender identity and expression;

(iii) decide whether and when to be sexually active;

(iv) choose their sexual partners;

(v) have safe and pleasurable sexual experiences;

(vi) decide whether, when and whom to marry;

(vii) decide whether, when an…