Women who use injection drugs: the social context of risk.

R elatively few studies — especially Canadian ones — have addressed the problems and issues specific to women who are injection drug users. Much of what we can say about this group of women must be extrapolated from the literature on HIV/AIDS and from reports on drug treatment programs in the US. Notwithstanding the lack of information about them, women who inject drugs are increasingly visible in our society. Needle-exchange and harm-reduction programs in Canada report significant use by women: for example, women comprise 35% of the approximately 6000 registrants of the Vancouver Needle Exchange and were represented in the same proportion in the cohort of injection drug users involved in the Vancouver Injection Drug Use Study (VIDUS). Approximately 20% of injection drug users recruited in Montreal for an observational study of risk behaviours and HIV infection were women. The urgency of the problems facing these women challenges physicians to develop a more sophisticated understanding of the culture and context in which they live and a more informed approach to their health care.