Women who use drugs are more vulnerable to HIV infection than male drug users. They share injection equipment and are often "second on the needle." Engagement in sex work and low levels of condom use add to their risk of infection. At the same time, women face greater obstacles to accessing the services they need to protect their health. This report examines women's access to harm reduction, reproductive health, and HIV and AIDS services in five countries: Azerbaijan, Georgia, Kyrgyzstan, Russia, and Ukraine.