Harm reduction theory: Users’ culture, micro-social indigenous harm reduction, and the self-organization and outside-organizing of users’ groups

Abstract

This paper discusses the user side of harm reduction, focusing to some extent on the early responses to the HIV/AIDS epidemic in each of four sets of localities-New York City, Rotterdam, Buenos Aires, and sites in Central Asia. Using available qualitative and quantitative information, we present a series of vignettes about user activities in four different localities in behalf of reducing drug-related harm. Some of these activities have been micro-social (small group) activities; others have been conducted by formal organizations of users that the users organized at their own initiative. In spite of the limitations of the methodology, the data suggest that users' activities have helped limit HIV spread. These activities are shaped by broader social contexts, such as the extent to which drug scenes are integrated with broader social networks and the way the political and economic systems impinge on drug users' lives. Drug users are active agents in their own individual and collective behalf, and in helping to protect wider communities. Harm reduction activities and research should take note of and draw upon both the micro-social and formal organizations of users. Finally, both researchers and policy makers should help develop ways to enable and support both micro-social and formally organized action by users.

Human rights and access to hepatitis C treatment for people who inject drugs

“…Human rights principles of participation, accountability, non-discrimination and transparency are consonant with the long history of work by PWID to make HIV services more responsive to their needs (Friedman et al, 2007), and with recent community calls urging that HCV treatment leave no one, including PWID, behind (MDM & INPUD, 2014). Whether or not framed explicitly in rights language, reform of HCV treatment should be grounded in a fundamental human rights claim: that injection of illicit drugs should not mean exclusion from citizenship, participation or quality, affordable, accessible care.…”

A reply to Bongmba, Floyd, Palmer, and Susser: An invitation to dialectics

“…She suggests that in a future article we might provide more details on how people who injected drugs in New York in the late 1970s came to understand their peril from AIDS and to adapt their behavior to reduce their risk. As it turns out, we have done this already in Friedman et al (2007) and Rockwell et al (2006).…”

Strategies for achieving universal access to hepatitis C virus prevention and care for people who inject drugs

“…Human rights principles of participation, accountability, non-discrimination and transparency are consonant with the long history of work by PWID to make HIV services more responsive to their needs (Friedman et al, 2007), and with recent community calls urging that HCV treatment leave no one, including PWID, behind (MDM & INPUD, 2015). Whether or not framed explicitly in a 'rights-based' language, reform of HCV treatment should be grounded in a fundamental human rights claim: that injection of illicit drugs no longer be a criminal act and should not mean exclusion from citizenship, participation or quality, affordable, accessible care.…”