National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia.
Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Ukrainian Institute for Public Health Policy, Kiev, Ukraine.
National Addiction Centre, King's College London, London, United Kingdom.
European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal.
Women-specific factors exist that increases vulnerability to drug-related harms from injecting drug use including bloodborne viruses (BBV), but gender differences in BBV prevalence have not been systematically examined.
We conducted meta-analyses to estimate country, regional, and global prevalence of serologically-confirmed HIV, hepatitis C (anti-HCV) and hepatitis B (HBsAg) prevalence in people who inject drugs (PWID) by gender. Gender differences in BBV (relative risks, RR in women vs men) were regressed on country-level prevalence and inequality measures.
Gender differences varied by countries and regions. HIV prevalence was higher among women than men in Sub-Saharan Africa (RR=2.8, 95%CI 1.8-4.4) and South Asia (RR=1.7, 1.1-2.7); anti-HCV was lower among women in the Middle East and North Africa (RR=0.6, 0.5-0.7) and East and Southeast Asia (RR=0.8, 0.7-0.9). Gender differences varied with country-levels of BBV in the general population, human development, and income distribution.
HIV infection was more prevalent in women who inject drugs compared to their male counterparts in some countries, but there is between and within regional variation. In countries where women are at higher risks, there is a need to develop gender-sensitive harm reduction services for the particularly marginalized population of women who inject drugs.