This paper is based on a review of literature as well as a series of community interviews with women who use drugs who are living with HIV in different regions of the world as well as selected other stakeholders who work in the fields of HIV and harm reduction. The experience of women who use drugs and live with HIV along the HIV service continuum and factors that impact their health and rights are explored. The paper seeks to identify the key barriers faced and make recommendations on how to address them for improved health and rights outcomes.