Substance use disorders affect nearly 6% of the world’s population and are associated with a variety of health problems and risks, including infectious diseases and mental health conditions. Women who use drugs are a particularly vulnerable population who face additional barriers to treatment. In Georgia, women who use drugs remain a hidden and stigmatized population. Little is known about their drug use patterns and health care needs. We propose a small, exploratory, biobehavioral study of drug users (both injecting and non-injecting) in Georgia to: (1) describe and analyze drug use patterns, (2) assess the burden of mental health conditions, hepatitis C virus (HCV) infection, hepatitis B virus (HBV) infection, and syphilis, and assess risk factors for these conditions, and (3) assess access to and utilization of health services for drug treatment, mental health services, and reproductive health services. This study includes two components: behavioral, face-to-face interviews and biological testing for hepatitis C, B and syphilis. This study will provide valuable, previously unknown information on the prevalence of these major diseases and provide critical insights into barriers and enablers to access health and substance abuse treatment. The data can be used by service providers and researchers to develop evidence-based interventions to increase access to treatment for this population. In addition, this project will strengthen local capacity by providing valuable research training and ethical behavior experience to BAU Batumi International University students and staff when working with stigmatized populations.

Project Objective
The project aims to assess the health status and healthcare needs of women who inject and non-inject drug users in Georgia.
Project Objectives
Objective 1. Describe and analyze drug use patterns among women who use drugs in Georgia, including the types of drugs used, frequency of drug use, and drug use networks. In structured face-to-face interviews, we will include questions about the types of drugs used by participants in the past 12 months, the frequency of drug use in the past month (e.g., number of days of drug use, number of drugs used, etc.), where drugs are purchased, and with whom the participant usually uses drugs.
Sub-objective of Objective 1: Validate the Drug Use Screening Test (DAST) scale among female drug users.

Objective 2. Assess the status and risk factors for mental health disorders, hepatitis C virus (HCV) infection, hepatitis B virus (HBV) infection, HIV infection, and syphilis. To achieve this, we will first determine the prevalence of these disorders in our sample. Mental health disorders will be measured using the BD-II and GAD-7 scales. Information on HIV status will be self-reported during the face-to-face interview. For HCV, HBV, and syphilis, we will obtain the necessary samples through blood tests. After collecting this data, we will assess the risk factors associated with each disease, including frequency of drug use, type of drug used, age, and stigma associated with healthcare.

Objective 3. Assess access to and utilization of drug treatment, mental health services, and reproductive health services. We will conduct face-to-face structured interviews to identify barriers (e.g., stigma, cost, geographic location, etc.) and facilitators (e.g., free services, social support, etc.) to access and utilization of drug treatment, mental health, and reproductive health services. We will also measure the number of services used in the last 12 months.
Subtask of Goal 3: Validation of the Reproductive Autonomy Scale (RAS) among women who use drugs in Georgia.
 

Tangible Results 
• A final, cleaned dataset of women who use drugs in Georgia.
• Analysis code for each objective published on GitHub.
• A final report, as described in the “Reporting Frequency” section below, detailing the research methodology and findings.
• Three to five published manuscripts, at least one for each objective.
• Any presentations or abstracts to be presented at conferences, to BAU staff, NGOs, or other organizations.
Expected Impact
Women who use drugs in Georgia are a significantly understudied population, and little is known about their health status and needs. This study will directly address this knowledge gap by providing valuable, previously unknown information on the prevalence of major diseases, including mental health conditions, HIV, hepatitis C, and sexually transmitted infections. In addition, our data will provide critical insight into barriers and enablers to health and drug treatment.
The results will have tangible impacts at both systemic and local levels. The data can be used by service providers and researchers to develop evidence-based interventions to increase access to care for this population. For example, future interventions could target the reduction of health-related stigma experienced by women who use drugs. We will also provide detailed descriptions of drug use patterns, which will help develop more targeted and effective treatment programs.
Finally, this project will strengthen local capacity by providing BAU students and staff with valuable research training and experience in ethical behavior when working with highly stigmatized populations. We plan to actively involve BAU students at all stages of the research process to ensure that the knowledge gained from this project is maintained beyond the funding period.
 

სერვისის მიმწოდებლები
მტკიცებულებებზე დაფუძნებული ინტერვენციების შემუშავება მოვლაზე ხელმისაწვდომობის გასაზრდელად.