This gender analysis of harm reduction services for young people who use drugs (PWUD) “Assessment of gender sensitivity of the drug harm reduction program for youth in Serbia“, published by our member organisation Prevent from Novi Sad, was conducted within the Erasmus+ regional project “Creating Gender-Based Programs for Young People Who Use Drugs,” with the aim of identifying gender-related barriers, gaps, and opportunities in existing programs. The study places a strong focus on the needs and lived experiences of young PWUD, including those of diverse gender identities and sexual orientations, while assessing the level of gender sensitivity and inclusiveness of current services. In 2025, the harm reduction landscape in Serbia is marked by the absence of an updated national strategy, weakening multisectoral cooperation, and the exclusion of civil society organizations (CSOs) from policymaking processes. Existing policies only partially recognize harm reduction and lack gender-specific or transformative approaches, while the legal framework remains repressive and discourages service access. Additionally, there is a significant lack of gender-disaggregated data and gender analysis in public systems, alongside documented discrimination against women, trans, and LGBTQAI+ individuals. Despite these challenges, CSOs continue to play a crucial role as primary service providers, offering essential support such as sterile equipment, testing, counselling, and safe spaces, though they face limited funding, administrative barriers, and declining international support, putting especially gender-sensitive and youth-focused services at risk of closure.
The findings highlight that women – particularly sex workers, Roma women, and trans and non-binary individuals – face multiple and intersecting forms of marginalization, compounded by the lack of gender-responsive services and systemic exclusion from public institutions. There is a clear need for more inclusive, gender-sensitive, and accessible approaches, including mobile and night outreach, integrated legal and healthcare support, and safe shelters. While CSOs are actively developing anti-stigma protocols, gender-neutral spaces, staff training, and protection mechanisms, their efforts remain constrained by unstable funding. Accordingly, the recommendations emphasize the urgent need to integrate a gender perspective into public policies, ensure sustainable institutional funding for CSOs, reform punitive legal frameworks, and enable meaningful participation of both CSOs and young PWUD in decision-making. At the organizational and programmatic levels, priorities include diversifying funding sources, strengthening partnerships, preserving core services, expanding peer-led and gender-sensitive programs, improving outreach and communication, addressing violence, and investing in continuous monitoring and staff capacity building. Overall, a coordinated and gender-responsive systemic shift is essential to ensure equitable, sustainable, and effective harm reduction services in Serbia.
The report, in Serbian, is available following this link>>>.
Prevent also published a comparative report which is the result of collaboration between civil society organizations from three countries: Prevent from Novi Sad, HOPS from Skopje, and Sananim from Prague. It provides a comprehensive overview and comparison of three national gender analyses of harm reduction programs conducted in Serbia, North Macedonia, and the Czech Republic during 2025, using a shared methodology. The main objective was to identify gender-related barriers, gaps, and opportunities within existing harm reduction services, with a particular focus on the needs and experiences of young people who use drugs, including individuals of diverse gender identities and sexual orientations. The report examines the extent to which services are gender-sensitive, inclusive, and responsive to the specific needs of users, taking into account the influence of gender norms, identities, and structural inequalities on both access to and quality of services.
The analysis combines two key components: a desk review of existing strategies and policy frameworks, and qualitative insights gathered through semi-structured interviews with organizations working directly with marginalized communities, including people who use drugs, sex workers, LGBTI+ individuals, and youth. To ensure a standardized and evidence-based assessment, the evaluation of programs and policies was conducted using the World Health Organization’s Gender Responsive Assessment Scale (GRAS), which enabled the identification of levels of gender responsiveness as well as critical gaps across the three national contexts. This comparative approach not only highlights shared challenges but also provides a foundation for developing more inclusive, gender-responsive harm reduction policies and practices across the region.
The report is available in Serbian following this link>>>.
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