Theme: Social Science & Policy Research Year: 2024
Background: In recent years, Europe has witnessed fluctuating HIV incidences among people who use drugs (PWUD). Hepatitis C transmission remains a significant concern within this population. These trends not only affect individual health but also have broader public health and human rights implications. This study explores policy, legal and practice barriers for PWUD to accessing HIV and co-infection(s) services, and pathways for equitable access.
Methods: This study covers 10 European Union Member States, selected for their diverse epidemiological, political, geographical, and economic contexts. Data was collected between April and August 2023, using a standardised questionnaire. Respondents were experts from HIV service organisations (AAE members).
Results: Responses indicate that pervasive stigma and discrimination against PWUD in healthcare settings, foster mistrust and service avoidance. HIV service organisations emphasised that criminalising drug use fuels this stigma, hindering harm reduction service expansion, including needle exchange programs and drug consumption rooms. All examined countries have limited or no harm reduction services in prisons due to policy and practice barriers, and a lack of commitment from prison authorities. Positive trends include increased availability of HIV/HCV treatments without requiring drug abstinence. However, the disconnection between harm reduction and other health and social services, coupled with punitive policies, hinders the continuity of HIV/HCV testing and treatment.
Conclusion: Addressing these barriers requires shifting legal and political perceptions of drug use and harm reduction towards policies grounded in social justice and human rights. Decriminalising drug use and possession would enable the expansion of life-saving harm reduction services and contribute to reducing the stigma against PWUD, thereby improving their access to health services. Overcoming existing challenges that affect the human rights and health of PWUD necessitates policy reforms to ensure equitable access to healthcare in all settings, promote integrated service delivery, and ensure that affected individuals have a voice in policymaking.