Despite the significant HIV treatment advance of highly active antiretroviral therapy (HAART), many HIV-positive women are not realizing its benefits. While recent studies have identified female intravenous drug users (IDUs) and sex workers as at high risk of HIV infection, there have been few studies on their utilization of HIV treatment and services. In the current study, researchers evaluated the needs of women engaged in survival sex and their access, use, and acceptance of HAART.

During November 2003, a baseline needs assessment was conducted among 159 women attending a low-threshold drop-in center serving sex workers in Vancouver's Downtown Eastside, a highly marginalized population coping with multiple morbidities, unstable housing, and increased risk of drug use and STD infection. Researchers used cross-sectional data to describe the population's sociodemographic characteristics, drug use, HIV/hepatitis C testing and status, and attitudes about HAART.

Among those surveyed, reports of cocaine injection, heroin injection, and smokeable crack cocaine use were high. Preliminary findings suggested a high uptake of health and social services, but only 9 percent of the women reported HAART use. Barriers to treatment access were largely attributed to erroneous information and conceptions about treatment.

The study emphasized the potential to reach this marginalized population through community interventions and women-specific services, and it provided a valuable baseline of information on a group that is largely outside of HIV care.

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