Twice Stigmatized: Provider's Perspectives on Drug-Using Women in the Republic of Georgia

Abstract

This study examined attitudes and perspectives of 34 health service providers through in-depth interviews in the Republic of Georgia who encountered an injection drug-using woman at least once in the past two months. Most participants' concept of drug dependence treatment was detoxification, as medication-assisted therapy was considered part of harm reduction, although it was thought to have relatively better treatment outcomes compared to detoxification. Respondents reported that drug dependence in women is much more severe than in men. They also expressed less tolerance towards drug-using women, as most providers view such women as failures as a good mother, wife, or child. Georgian women are twice stigmatized, once by a society that views them as fulfilling only a limited purposeful role and again by their male drug-using counterparts. Further, the vast majority of respondents were unaware of the availability of specific types of drug-treatment services in their city, and even more did not seek connections with other service providers, indicating a lack of linkages between drug-related and other services. The need for women-specific services and a comprehensive network of service linkages for all patients in drug treatment is critical. These public health issues require immediate consideration by policy makers, and swift action to address them.

Keywords:

• injection drug use
• Republic of Georgia
• service providers
• stigma
• women

Acknowledgments

This research was supported by NIDA grant R01 DA029880. The authors thank Marina Chavchanidze, Natia Topuria, Mariam Chelidze, Lika Kirtadze, Lile Batselashvili, and Mariam Sinjikashvili for conducting and transcribing interviews.