The Middle East and North Africa Harm Reduction Association (MENAHRA) has been working towards supporting evidence based harm reduction programs within the Middle East and North Africa (MENA) region for the past decade. As a leading organization and network on harm reduction in the MENA, MENAHRA has conducted a number of researches in collaboration with diverse experts and research teams, in order to contribute to the availability of region-specific literature and evidence.

Following a number of Operational Researches conducted with different focuses within the harm reduction and drug use fields, this Operational Research explores and assesses the situations and risks faced by People Living with HIV (PLHIV) who use drugs. There is no denying that PLHIV and People Who Use Drugs (PWUD) alike are stigmatized and highly discriminated against in our region, and PLHIV who use drugs are exposed to double stigma, often preventing proper access to essential life-saving services.

This report investigates and details the health-related harms, stigma and discrimination, service access and adherence barriers, as well as the impact of current (if existing) harm reduction strategies among PLHIV who use drugs. The results of this report should guide decision-makers and civil society organizations towards the provision of more comprehensive and accessible harm reduction and HIV services.

MENAHRA would like to thank Ms. Oumnia Abaza for producing this report under an exceedingly tight schedule and many constraining obstacles. We would also like to extend a warm thank you to our strategic partners, UNAIDS and WHO, for their continuous collaboration and support. And last but not least, thanks to all those who contributed to the compilation of this report, the MENAHRA team, and the Global Fund for making the production of this report possible.