HIV Risk Reduction Interventions for Substance-Using Women

Substance-using women constitute a key population at elevated risk of acquiring and transmitting HIV, owing to intersecting behavioural, structural and biomedical factors. Interventions have therefore evolved from singular behaviour-change models towards integrated, multilevel approaches that combine biomedical prophylaxis with targeted behavioural and structural support. Women-focused programmes address unique gender-specific vulnerabilities such as intimate partner violence, economic marginalisation and limited access to healthcare. Harm-reduction strategies—including needle-and-syringe exchanges and alcohol-moderation counselling—are increasingly paired with sexual-risk reduction modules that build skills in condom negotiation and safer practices. Biomedical advances such as pre-exposure prophylaxis (PrEP) and ‘treatment as prevention’ via antiretroviral therapy (ART) demand adherence-support interventions tailored to women who use substances. Peer-facilitated, community-based models have demonstrated capacity to improve engagement and retention, while trauma-informed frameworks help to alleviate the compounded impact of violence and substance misuse. Implementation science has begun to elucidate optimal pathways for scaling up these interventions in real-world settings, highlighting the importance of stakeholder engagement, delivery in primary care and the adaptation of proven protocols to diverse cultural contexts. Globally, refined combination prevention strategies are now positioned to curb HIV incidence among substance-using women by bridging gaps between behavioural change, biomedical tools and social support.

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HIV Risk Reduction Interventions for Substance-Using Women publication trend

The graph below shows the total number of articles in hiv risk reduction interventions for substance-using women across all publications each year (not limited to Nature Index journals).

Technical terms

Antiretroviral therapy (ART): A combination of medications that suppress HIV replication, reduce viral load and improve immune function.

Pre-exposure prophylaxis (PrEP): The use of antiretroviral drugs by HIV-negative individuals to prevent acquisition of HIV.

Biobehavioural intervention: An integrated approach combining biomedical tools (such as ART or PrEP) with structured behavioural counselling to reduce HIV risk.

Harm reduction: Strategies and policies designed to minimise negative health, social and legal impacts associated with drug use without necessarily requiring abstinence.

Trauma-informed care: A framework that recognises and responds to the pervasive impact of trauma, ensuring that services are delivered in a way that avoids re-traumatisation.

References

1. Initial Feasibility and Acceptability of a Comprehensive Intervention for Methamphetamine‐Using Pregnant Women in South Africa. Psychiatry Journal (2014).
2. Outcomes of Implementing in the Real World the Women's Health CoOp Intervention in Cape Town, South Africa. AIDS and Behavior (2021).
3. ‘We have goals but [it is difficult]’. Barriers to antiretroviral therapy adherence among women using alcohol and other drugs living with HIV in South Africa. Health Expectations (2022).