aem 2014
TRANSCRIPT
Harm Reduction and
HIV Prevention:Working with sex workers, substance users, and other criminalized communities
Amna Shaikh, Lindsay Roth, and Kahn Miller of
Objectives
Introductions Continuum of acceptability Frameworks and definitions Applications in practice Discussion
This is a safe space Confidentiality: What’s shared here stays
here, what’s learned here leaves here One Mic Make Room, Make Noise Ouch/Oops If you don’t know - ask! Speak from the “I” Avoid assumptions Please do not record this presentation (the
slide show with bibliography and notes will be made available)
Who We Are, What We Do
All volunteer, grassroots direct-service and advocacy organization for and by women in Philadelphia’s sex trade, with a focus on women surviving in the street economy in Kensington.
Barriers to care are material, social, and structural. Services include: •late night street outreach •bad date sheet
•home deliveries •case management •health & safety tips
•overdose response training •rape and assault referrals
•ladies night drop-in
What is Harm Reduction?
What is Harm Reduction?
A public health theory addressing behaviors that carry risk.
We all do things we know are bad for us, and only the individual can decide what measures to take to mitigate harm
Those who engage in these behaviors should have a leading voice in any organization or program they utilize
Continuum of Acceptability
Not OK for anyone ever (in the history of ever)OK for some (over there, far away)Fine but not a preferred practiceGood for others, not good for meGood for others, good for me
Consider these as you move through the continuum
Debrief
What was the first thing you thought of?
Have you always felt this way? How would your position change if
this were a continuum of risk? What other factors influenced your
position?
Criminalization Oppression via state control of body
(legal gender, incarceration, condoms as evidence, drugs & paraphernalia) and mind (access to education/information, mental health care, definition of disease)
Can be explicit in law or how laws are enacted/enforced, and replicated through other institutions/centers of power (education, medicine, media and pop culture)
Not a vacuum but a wave
Frameworks (everybody has one)
Sex work as work Substance use vs.
Drug Abuse Theory of
Intersectionality
These frameworks acknowledge the material, social,
cultural, and spiritual impacts of
criminalization
Sex Work as Work
Sex Work, Sex Trade, Survival Sex Work – it doesn’t need currency to be commerce
Focus on the sex worker Honors Autonomy (Choice/Agential
Choice) Free of stigma, implies alliance Provides for a more comprehensive
understanding of what exploitative forces may be at work (interpersonal, institutional, or otherwise)
Substance Use vs. Drug Abuse
Language creates our reality Our reality, as providers, should be free of bias Create a space for individuals to self-identify
and/or qualified professionals to properly diagnose
Consistent with evidence based practices and contemporary research
Substance Dependent
Chaotic Use
Supporting
Addict
Rock-Bottom
Enabling
There is a rainbow of options between chaos and
abstinence!
Intersectionality
Criminalization is experienced disproportionately under multiple forms or systems of oppression, domination, or discrimination. These frameworks must be considered
within the theory of intersectionality.
Application in Practice
Harm Reduction approaches to serving historically vulnerable, marginalized and
oppressed populations mitigate the impact of criminalization –
especially in HIV treatment and care.
…So how do we do this?
Our Suggestions Know your own boundaries Affirming and appropriate language and
visual presentation Check your knowledge base Seek ongoing education Know the laws and policies that impact
your clients and yourself “Nothing about us without us” from the
waiting room to the board room Meet people where they are at –
literally! Use strengths based models
(not the) Final Discussion
How can we apply these frameworks in context in which we are all survivors of criminalization?
Thank You!Please stay in touch
Amna Shaikh, Lindsay Roth & Kahn Millerwww.projectsafephilly.org
[email protected] by our table!