Making Outreach Matter: Exploring Interventions and Decision-Making for Two Intravenous Drug User Populations in Vancouver’s Downtown Eastside

Within the intravenous drug user (IDU) population of Vancouver’s Downtown Eastside (DTES), female commercial sex workers and Aboriginal women are overrepresented. These two groups are especially vulnerable to unique sets of health and social challenges that may be related to their substance dependency, including increased susceptibility to sexually transmitted infections, physical violence, psychological trauma and malnutrition. Their social challenges can include increased contact with law enforcement, lower education, unemployment and inability to access community support. The needs of these two groups both intersect and diverge based on a series of factors. There are currently numerous services and interventions that target intravenous drug using women, including emergency mental health counselling, addictions treatment and recovery, harm reduction (both for IDU and commercial sex work) and general support groups. However, the rates of use of these services by commercial sex workers and Aboriginal women are relatively low. This suggests that many women either choose not to or cannot make use of the available health services and interventions. In order for these interventions to effectively help these two groups of women in coping with deeply interconnected health and social challenges, these factors must be investigated, addressed and understood within a complex matrix. Ashley White is conducting an in-depth study to explore the characteristics, perceptions of health services, and needs of commercial sex workers and Aboriginal women practising intravenous drug use. Her findings will provide essential insight into potential ways that health planners can offer accessible services that better meet the requirements of these women.