Safe Injections and Harm Reduction

Earlier this semester Trent Oxfam and the Centre for Gender and Social Justice co-hosted a panel discussion about contemporary HIV narratives, featuring Ariel O’Neil, the women’s health coordinator at PARN; and David Macmillan, a freelance sexual health educator from Ottawa. The goal of this event was to facilitate better informed discussion regarding HIV among Trent students and to dispel harmful myths. The discussion centered around harm reduction, preventing HIV transmission and the links between marginalization, poverty, trauma and HIV status. Both Macmillan and O’Neil stressed that safe injection sites and community support free of stigma are essential to effective care and preventing further transmissions of the HIV virus.

Oxfam’s work centers around poverty alleviation through women’s rights and a large part of their work internationally has revolved around preventing transmissions of HIV/AIDs in the global south. A part of my job since I was hired as the Trent Oxfam coordinator has been researching and understanding the links between gender, race and citizenship status and poverty, both on a global scale and here at home in Peterborough. There is often a harmful assumption that HIV/AIDs is a problem exclusive to the global south and that HIV/AIDs in the western world is exclusive to the gay community. This is categorically untrue. For the most part AIDs is not an issue which faces the majority of Canadians, due to our geographical privilege and access to medication. However, the HIV virus, which is transmitted through blood, sexually or via intravenous drug use, is an issue facing Canadians today.

Because Canadians have access to PrEP (Pre-Exposure Prophylaxis) a preventative drug taken to prevent the transmission of the HIV virus, as well as access to safer sex supplies such as condoms and barriers, it is imperative that they have access to safe injection sites as well. Our understanding of HIV transmission needs to be linked to a better understanding of substance use and the social determinants for health. For example, Peterborough has the highest unemployment rate across Ontario, with many residents living below the poverty line. According to a study by The Family Informed Trauma Treatment Centre, families living in urban poverty often encounter multiple traumas over many years due to a variety of factors such as lack of resources, stigma, racialization, etc. Furthermore, they are less likely than families living in more affluent communities to have access to the resources that may facilitate the successful negotiation of their traumatic experiences. This can lead to PTSD, intergenerational trauma, and failed relationships.

Harm reduction aims to understand and address the complex relationship between trauma, addiction and marginalization without further stigmatizing substance use or HIV status. It rejects the narrative that shame can perpetuate positive changes in behaviour. Instead, harm reduction acknowledges the relationship between shame and substance abuse and the role which it plays in preventing high risk individuals from seeking information about their HIV status. In other words, a harm reduction approach to substance use and overdose prevention acknowledges that poverty, trauma and marginalization all have a pre-existing relationship with shame and stigma and that this shame and stigma perpetuates further harm to already vulnerable communities.

As Peterborough introduces its first overdose prevention site, I invite us all to take a more compassionate and intersectional look at substance use and the role of harm reduction in our community. In understanding that poverty, marginalization and trauma are all linked to substance abuse, we can begin to see a larger picture of community healing. This site has the potential to prevent future transmissions of the HIV virus and prevent needless infections and overdose related deaths in our community. We should all be proud to live in a community that is prioritizing harm reduction over shame and stigma.