Negotiating Harm Reduction

1. Negotiating Harm Reduction in the context of an HIV Epidemic Nicole White, Executive Coordinator AIDS Saskatoon

2. Nicole White, Executive Coordinator

3. Outline: • Defining our vulnerable populations • Discuss the concept of “Health” and how it applies to HIV Prevention • Syndemics • Explore AIDS Saskatoon’s model of Harm Reduction • Best Practices: how to work with a community-based organization. • Navigating our Current Climate • ASO limitations

4. Identifying Common Threads

5. Syndemic: (n.) a cluster of epidemics that act additively to predict other epidemics (adj.) of or pertaining to such a cluster* www.cdc.gov/syndemics

6. Re-Centering our Approach

7. Our interconnected work: Societal level: homophobia, heterosexism, the criminalization of HIV, racism, immigration law, migration Community Level: racism within communities, norms around unsafe sex, lack of a safe space for people living under the poverty line Organizational Level: cultural competence of organizations, capacity to serve diverse populations, inclusive language policies, access to approriate/safe health care. Interpersonal level: couple communication, abusive relationships, loss of traditional ties with families/culture, safer sex negotiation Individual level: isolation, drug/alcohol use,depression, lack of knowledge, personal life stressors.

8. AIDS Saskatoon • Mission Statement AIDS Saskatoon is the primary AIDS service organization serving Central and Northern Saskatchewan. We provide outreach, education, and support for people living with and affected by HIV/AIDS and Hepatitis C (HCV). No questions asked. • Brief History

9. Addition to Maslow’s Hierarchy (for folks who use drugs)

10. Our Brand of Harm Reduction • Meet people where they are at. • Services we provide: • 601 Outreach-The 601 is a place where anyone can come to access services, seek information and support or simply to get in off the streets. There is no intake process, glass cages or proof of HIV status required. People are greeted in the same way, whether they are a donor, volunteer, student, service provider or someone who needs help.

11. Why Does AIDS Saskatoon need a Drop-In Centre? People need a place to feel warm, safe, and cared for. Each person who walks in our doors is a person of value. Basic needs: Food, Shelter, Laundry services, Telephone, Computer, and Coffee Needle Exchange Folks come in to chill, read, hang out, eat, watch TV, use the phone, whatever they need! When they are ready, they can also access counselors and our Support Services Coordinator.

12. Other services we provide: • Education and Prevention • IFS • Support Services • Outreach Centres • Projects in the works: Transport for HIV positive individuals for Doctor’s appointments • Environmental scan for HIV Positive New Canadians

13. Navigating our Current Climate • Harm Reduction is a world-recognized approach to reduce new HIV transmissions. • Federal Government • Local situation • Media Limitations: • a 30 second story does little to capture what is going on and can simply further stigmatize the issue (i.e. CTV story from last week.) • It’s hard to keep the issue at the fore-front because saucy issues like sex and drugs are popular, but language and tone are hard to translate for someone not working in this field.

14. Common Misconceptions about Harm Reduction “Harm Reduction enables people to keep using” By definition, enabling means making excuses, bailing out, denying or ignoring the problem. Harm reduction means sitting calmly with people and hearing the bald truth, then figuring out ways to reduce the harm caused by the individuals' reality. Enabling keeps people sick; harm reduction encourages health. At AS, we are only willing to help individuals as far as they are personally willing to work. “Shouldn’t you just teach people that drugs are bad?” Tell that to a diabetic, someone who has cancer, migraines, surgical pains, sports injury, bipolar mood disorder, high blood pressure, heart disease, schizophrenia, or HIV infection. Drugs can range from lifesavers to killers. It’s all in how you use them! Many folks I know are self-medicating for past trauma or an undiagnosed mental health issue.

15. What I’ve learned: Reconsider what recovery looks like. I am not tough enough to survive the streets of Saskatoon. Let’s honour that resiliency in our folks. Health is important, but so are food and shelter. How can you make your community a more inclusive space? What are other models out there for housing that we haven’t considered yet? (i.e. wet shelter, low barrier housing.) One-on-one conversations are most effective for creating change in the community.

16. Best Practices of working with ASO’s • So you want to work with an ASO? • First, thank you for thinking of us! • Before you do so, ask yourself why? Ask yourself, does this benefit the organization I want to work with? How does this impact the community? • Clear intentions are truly appreciated. Find out your community needs first—don’t assume you know what the community needs. • Examples of partnerships ‘gone wrong.’

17. Moving Forward: It’s our responsibility to shift the public discourse around harm reduction, mental health and addiction, and housing dialogue. Have an honest conversation with individuals accessing your services. What are the gaps they see? Just asking can make all the difference. Harm Reduction isn’t just about needles. What else does it include? Your mission: When you get home tonight, talk to your friends and family about HIV and what we need to do to create a safer space for everyone. A knowledgeable, compassionate community can make all the difference!

18. Keep in touch! Nicole White Executive Coordinator AIDS Saskatoon admin@aidssaskatoon.ca 1.800.667.6876 306.242.5005 www.aidssaskatoon.ca Check us out on facebook and twitter!!