The WINGS intervention to reduce violence against women, led by Dr. Louisa Gilbert, has expanded through global partnerships and continued to provide services to women in need during the pandemic. The former WINGS India project coordinator, Dr. Harjyot Khosa, shared highlights from India.
Trigger alert: This article contains brief descriptions of violence against women.
The WINGS intervention to reduce violence against women has expanded through global partnerships and continued to provide services to women in need during the pandemic. The update below was compiled with significant input from Dr. Harjyot Khosa, Project Coordinator for WINGS India.
The risk of violence against women who use drugs is significant
Several women agreed: If a man slaps me, it means he loves me. This is how men behave. Other women reported that their clients threatened to burn them, often burning their hair on the stove. Some were fearful because their husbands threatened to report them for using alcohol or drugs so their children would be taken from them. All suffered from forms of economic violence, or a lack of control of their own finances, and therefore, their own safety.
What did these women all have in common?
They were participants in the India pilot of Women Initiating New Goals for Safety, or project WINGS, led by SIG’s co-Director Dr. Louisa Gilbert.
WINGS was designed by Dr. Gilbert and other scientists at SIG to be flexible in communities and countries with minimal resources and address the problem of violence against women at their must vulnerable. Intimate partners are the most common perpetrators of violence against women. The risk of violence is significantly higher with women who use drugs. Gender-based violence (GBV) and intimate partner violence (IPV) can be linked directly to HIV and other sexually transmitted infections (STIs) among women who use or inject drugs.
How WINGS reduces violence against women
WINGS offers an array of services to women using a community coordinated response, from developing safety planning strategies to strengthening their social support networks. The women who were slapped, for instance, learned that this behavior was abusive and not acceptable. They developed safety plans and networks.
Those suffering economic abuse learned how to sequester what little money they could away with trusted friends or relatives. Others needing treatment for drug dependence were given a path forward.
These women are often engaged in drug use, sex work, or living with HIV. WINGS helps link them to services through a screening process which typically involves identifying service needs and referrals using a trauma-informed care coordination tool.
Randomized controlled trials with women in correctional facilities in New York and pre-post trials of women who use drugs in Kyrgyzstan, Georgia and India have found that WINGS is effective in identifying and reducing physical, sexual, economic and emotional intimate and gender-based violence. There have been high rates of participation (95%) and, a six-month follow-up showed a reduction in intimate-partner and gender-based victimization as well as drug use. These results suggest the efficacy of WINGS.
WINGS is available in eight languages and has been implemented in six countries. The particular countries that WINGS have launched have one thing in common: There is a desperate need for easy to implement violence reduction services. The countries in which WINGS has launched -- The United States, Kyrgyzstan, Georgia, India, and the Ukraine -- were targeted due to the high rates of drug use and HIV in women. Work has now begun to adapt WINGS to both the Caribbean and Indonesia.
WINGS reduced violence against women in India
Most recently, WINGS successfully completed a trial in India, serving over 200 women. The project coordinator was Dr. Harjyot Khosa, who at the time was a project leader for the India AIDS Alliance (currently Dr. Khosa works for the International Planned Parenthood Federation).
The project began as a one-year pilot, then scaled up to three sites: Delhi, Pune, and Manipur. Several obstacles cluttered the path toward safety for these women. Many injected drugs and suffered from intimate partner violence. Others did not have the most basic autonomy afforded by having a marriage certificate and therefore a claim on their husband’s property. Some lived under bridges, or were sexually assaulted and thrown into the road. A few women died during the course of the study. Due to the stigma that surrounds these women, many of their deaths are undocumented, but causes of deaths can range from HIV (including co-infections with TB), overdose, cervical cancer, and unsafe abortions.
The third year of WINGS saw incredible results for these women. One woman, Reshma, said, "My husband is a drug user and when he is intoxicated he beats me. Talking to [WINGS staff] has made me better equipped to escape violence. I now avoid activities that would put me to risk of violence."
Another woman, Shalu, said "I did not know that condoms could avoid us getting infected. Now, I use condoms as well as distribute to my friends if they need one. I decline any service to my client if they refuse to use condoms. I have now realized the risks involved in our work and our drug use and how to fight back."
The main impact was decrease in violence after women made safety plans. After getting social and health services, women became more self-reliant and the economic violence also decreased.
My husband is a drug user and when he is intoxicated he beats me. Talking to [WINGS staff] has made me better equipped to escape violence. I now avoid activities that would put me to risk of violence.
Safety plans were the number one impact for women. They include identifying peer support in their neighborhood, or keeping their money with a trusted friend. Women who were sex workers also adopted specific safety plans with input from local organizations, since sexual safety is not usually included in standard safety plans.
Now... I decline any service to my client if they refuse to use condoms. I have now realized the risks involved in our work and our drug use and how to fight back.
Next steps for WINGS
The WINGS project team built their model to be sustainable, so that after the project ends, the women can still receive support. WINGS provides the intervention tool to a network of community partner organizations. The team in India advocated for the model to be utilized by the government. In fact, women registered through WINGS at the Indian site in Manipur are still receiving services. Future plans include reproductive health services for women engaged in sex work.
WINGS also continues to have an impact in Kyrgyzstan. SIG’s local WINGS partner, Danil Nikitin from the Global Research Institute (GLORI Foundation), has led the WINGS project in Kyrgyzstan since 2013. In the Spring of 2022, the WINGS “NPS” (novel psychoactive substances) intervention sessions will be piloted with community partner organizations in Kyrgyzstan. This intervention will be designed specifically for those using novel psychoactive substances such as stimulants and bath salts, a category of drugs increasingly growing in use. The intervention will also have an enhanced referral mechanism.
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