The key-role of outreach intervention in promoting the access of women who use drugs to social and health services

The key-role of outreach intervention in promoting the access of women who use drugs to social and health services Ponte, Isabel, Administração Regional de Saúde do Norte, DICAD, CRI Porto Oriental, Porto, Portugal

From the outreach work carried out at the CRI Porto Oriental and the 'Autoestima' Program, with women and transgender people who use drugs and do sex work (n= 67), in natural contexts (street, abandoned houses, etc.), we present a qualitative characterization of the social determinants of health found.

Outreach was considered the engine capable of expanding the knowledge and response capacity of services, through the empowerment of trans women and cis women, promoting access to the National Health Service and Specialized Services in Drug Addiction and Infectious Disease.

Methodology a) Ethnography and qualitative study of logbooks in Harm Reduction b) Analysis of registration forms c)Focus group

Women who use drugs experience: Social isolation, Low vocational education and training professional experience, Have sexual problems related to trauma, Shame, guilt, and low self-esteem, Low bargaining power in relation to risks, Sex work related to drug use, Vulnerability to partner violence, sexual violence, and abuse, Prevalence of psychological/psychiatric disorders Lack of support to attend health and social services, Lifestyles and living conditions associated to health risks, Legal problems, Stigmatization

Outreach was fundamental for this population and allowed us to observe the oblivion in which they live and the difficulties they face in accessing services. Community-based work contributed to the promotion of access to health services and social assistance. We conclude that a strong investment in outreach and public health is needed, as there are several social determinants of health that are in the origin of gender-based problems in addictive behaviours and drug-related harms.