HARM REDUCTION IS NOT A METAPHOR
Living in the 21st Century with Drugs, Intimacy, and Activism
A zine by What Would an HIV Doula Do? and Visual AIDS, at the invitation of MoMA PS1 for Homeroom on the occasion of Niki de Saint Phalle: Structures for Life and Gregg Bordowitz: I Wanna Be Well.
@momaps1 @visual_aids @wwhivdd Table of Contents
03 Indigenous Harm Reduction Canadian Aboriginal AIDS Network and the Interagency Coalition on AIDS and Development 04 Foreword: Harm Reduction Through Art and Activism Visual AIDS
08 Introduction Abdul-Aliy A. Muhammad
14 Harm Reduction = Life AIDS ACTION NOW!
16 Needle Exchange + Junkie Union + Jon Stuen-Parker What Would an HIV Doula Do?
22 Communities of Drug Use Tamara Oyola-Santiago
26 Desenredando la Maraña (Untangling the Weave) Bronx Móvil + El Punto en la Montaña and community activists
30 How To Get Narcan Jodi Bosin
32 Collectivities in Kensington David Oscar Harvey
37 Opioid Crisis is Still Not Just a ‘White’ Problem Abdul-Aliy A. Muhammad
40 Decriminalization vs. Legalization: What You Need to Know VOCAL-NY
43 BOOF IT! Sessi Kuwabara Blanchard
44 As a Woman With HIV, I Make My Sex Partners Sign a Disclosure Contract: Here’s Why Tiffany Marrero
47 Safer Sex + Play Fair + How To Have... What Would an HIV Doula Do?
51 Don’t Yuck My COVID Yum! Molly M. Pearson
57 Sustainable Safety: I Don’t Need You. I Want You. A Year of Feeling the Difference Nick Melloan-Ruiz
60 Is Holding Space a Harm Reduction Practice? What Would an HIV Doula Do?
65 Housing and Support + STAR House What Would an HIV Doula Do?
68 Abolition as Harm Reduction charles ryan long
72 Need Help With... Project SAFE
74 Harm Reduction Stickers Jade Forrest Marks and ripley soprano
76 EVERY TIME YOU SAY VOTING IS HARM REDUCTION another faggot moves to hell’s kitchen...* ripley soprano and Jade Forrest Marks
80 Voting is Not Harm Reduction Indigenous Action
82 Where Will HIV Be in 10 years? Alexander McClelland
88 Harm Reduction and the Archive Salonee Bhaman
90 Credits ↝ INTERAGENCY COALITION ON AIDS AND DEVELOPMENT 03 CANADIAN ABORIGINAL AIDS NETWORK From theintroduction ofthe2019report, and worldviews,combinedwiththebestofwhatWestern understanding tofacilitateinclusionofall Indigenous people however, harmreductioncanbecontentious andcontested. ways toengageinconversationsinformed byevidenceand reduction isawayoflife,rootedinIndigenousKnowledges successful, communitiesandcommunityleaders mustfind behaviours, neglectingthebroadersocialandsystem-wide a focusonusingsubstancesorsafersex.Indigenousharm issues thatcontributetoandintersectwithsubstanceuse reduction modelsfocustoonarrowlyonsubstanceusing for Indigenouspeoplesinthefirstplace.For substitution therapieshavebeenestablishedasamain legacy ofcolonization.AmongIndigenouscommunities communities, harmreduction=reducingtheharmsof “Mainstream harmreductionpracticessuchasneedle and overdoses.Whiletheseapproachesarelifesaving, colonization. Itisinclusiveof,butmuchbroaderthan, exchange programs,naloxonedistributionandopioid If Indigenousapproachestoharmreduction aretobe they arenotenoughtomakeameaningfuldifference Interagency Coalitionon AIDS andDevelopment world canoffer,andfocusedonmitigatingtheliving within Indigenouscommunities.Mainstreamharm Canadian AboriginalAIDSNetworkandthe approach inthepreventionofHIV,hepatitisC, Indigenous HarmReduction in ceremony,programsandcommunitylife.” Indigenous Harm Reduction
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FOREWORD 04 BLAKE PASKAL & KYLE CROFT Through Art and Harm Reduction Reduction Harm Foreword: Blake PaskalandKyleCroft Activism for VisualAIDS @visual_aids
FOREWORD 05 BLAKE PASKAL & KYLE CROFT messaging. SaintPhalle’s playful andcolorful drawings information mosteffectively throughcommunity-specific realized thattheycouldcommunicatethis life-saving Bordowitz, SaintPhalle,andmanyothers inthearts a lackofinformationand services fromthegovernment. developed and disseminated by activists respondingto harm reductionpracticeslikebleaching needleswere prevention practices.Safersextechniques and other offered littleguidanceabouttransmissionroutesand work inthe1980s,whengovernmentandhealthofficials Bordowitz andSaintPhallemadetheirfirstAIDS-related geographic lines. the impactsofepidemicalongracial,economic,and to manywithintheUSandsocialinequitiescompound saving medicationand healthcare remain inaccessible is stillbeginning”—wordsthatringtruetoday,aslife a decadeand a halflaterin2002,that “theAIDScrisis uncanny resonancewithGreggBordowitz’sreminder, if itwasavailableatall.SaintPhalle’swordshavean prevention wascloudedwithinaccuraciesand stigma, when informationaboutHIVtransmissionandAIDS with NikideSaintPhallewerepublished at atime These wordsfroma1988Peoplemagazineinterview And it’sjustbeginning.” situation that’ssuretobringoutthebestandworstinpeople. like AIDS...Youngpeopleneedtobecomeinvolved.AIDSisacomplex whether inenvironmentaldisasterslikeChernobylorhealth “The worldhasbeenexperiencingawholepatternofauto-destruction, — NikideSaintPhalle,1988
FOREWORD 06 BLAKE PASKAL & KYLE CROFT our collectivecommitment todissolvinginequity, continued relevance ofherwordsurgesustoexamine escalation ofwhitesupremacistandstate violence.The 19 inrelationtothethreatofglobalwarming andthe today asweconsiderpandemicslikeAIDS andCOVID- of auto-destruction,”herwordsfeeljust asrelevant that “theworldhasbeenexperiencinga wholepattern Though it’sbeenover30yearssinceSaint Phallestated the AIDSandCOVIDpandemics. Me”) ratherthanthestructuralinequities attheheartof onus oftheepidemiconpeoplewithHIV(“HIVStopsWith illustrated throughpublic healthcampaigns thatputthe emphasis onpersonalresponsibilityand “good choices,” However, thisnewparadigmhasalsoreinstated an and PrEPhavecreatednewmethodsofHIVprevention. viral treatment,U=U(undetectable=untransmittable), still teachabstinence-onlysexeducation),and transmission isnowwidelyavailable(thoughmanystates AIDS haschanged.InformationaboutsafersexandHIV effective formsofharmreduction,butthelandscape Today, condomsandothersafersexpracticesarestill and gaybars. pornographic shortsthatweredistributedtobathhouses Crisis, illustratedthatsafersexcould still besexywith shorts, madewithJeanCarlomustoforGayMen’sHealth by childrenandadults alike.Bordowitz’ssafersex and directstatementsthatcouldbeeasilyunderstood cut throughconcernsabouttaboosubjectswithsimple antiretro - ↝ FOREWORD 07 BLAKE PASKAL & KYLE CROFT surviving inthepresentday.Understanding thatevery about harmreductionasastrategyfornavigatingand at WhatWouldanHIVDoulaDo?tosharetheirinsights practices ofharmreductiontoday.Weaskedourfriends consider theworkoftheseartistsinrelationtoongoing Phalle’s exhibitionsatPS1,weVisualAIDSwantto On theoccasionofGreggBordowitzandNikideSaint structural inequtiesthatexacerbatetheepidemic. ization, stigma,housingjustice,mentalhealth,and the ment whilealsodrawingattentiontoissueslikecriminal educational informationaboutHIVpreventionandtreat HIV Criminalization,YouJustDon’tKnowItYet”provide Smart safersexkitsandbroasideslike“YouCareAbout educating aboutharmreduction practices.OurPlay activism, andviceversa, the rolethatbothplayin Visual AIDSunderstandshowartoftencoincideswith As anarts-based organization thatusesarttofightAIDS, mean tobeinacontinualandconstantpracticeofactivism? those mostinneed.Itpromptsthequestion:Whatdoesit social aestheticormetaphorsseparatedfromthelivesof particularly atatimewhenactivismisoftenreducedto tions thatextend beyond themuseum’swalls. create connections, andpromptmeaningfulconversa alities. Wehopethesematerialsprovide helpfultools, epidemics fromarangeofperspectives andposition living throughthesimultaneousAIDS,COVID, and opioid writing andartworkthatgrapples withthecomplexityof one navigatesapandemicdifferently,the zineassembles - - - - - INTRODUCTION 08 ABDUL-ALIY A. MUHAMMAD Harm Reduction is is Reduction Harm Not aMetaphor Introduction: Abdul-Aliy A.Muhammad (They/Them) 37yrsold @mxabdulaliy
INTRODUCTION 09 ABDUL-ALIY A. MUHAMMAD Their romancewasbrief.Itproduced me. Mydad ulti soon cometolove. visitation room,peekingintotheeyesofamanshe’d my dadwasfromadistance,herlookingacrossprison charges. Picturethis:mymother’sfirstflirtationwith she wasvisitingherbrotherTajiddin,alsojailed on drug located inNYState,wherehewasincarcerated,and Apartments housingproject.TheymetatFCIOtisville, mother, aBlackwomanwhogrewupintheWestPark father wasreleased.Butbeforethat,in1980,hemetmy The verdictwasoverturnedonAugust11,1982and my himself, arguingthathehad received ineffectivecounsel. however, whenhepetitionedforanappeal,representing set todoaconsiderableamountoftime.Thatchanged, jailed due tothetraffickingofnarcoticsin1974.Hewas and usedhisislamicnameSulahuddin Shakur,was My fatherGregoryTrice,Sr.,whowasfromGermantown crack epidemicintheUS. 1983, inPhiladelphia.Thiswasatthebeginningof I wasborntotwoBlackMuslimparentsonOctober26, Black system.From a youngage,Ihavehad a deep inextricably tiedtothe infrastructuresofananti- With thisbackground, Iconsidermyveryexistence I misshersomuch. the disease. My mother’s name was Melody Ellen Beverly. died of lungcancerin2012,afterafiveyearbattlewith system, upuntilhisdeathinSeptember 2013.Mymother mately foundhimselfengaged with thecriminal“justice” - INTRODUCTION 10 ABDUL-ALIY A. MUHAMMAD kidnapped Africans, someofwhomwerethrownover of stolenindigenouslandandthebrutal enslavementof our entanglementwiththemstartsatthe colonization harm? Well,Ialwaysliketostartwithsystems, because So whatisharmreduction,orrather,how dowereduce within mybones. own life,thisissomethingthatresonatesprofoundly bring onourselves.”WhenIthinkofmyparents,and writes, “Institutionshurtusfarworsethananypainwe ington,” harmreductiontherapistDavid Oscar Harvey For example,inatextentitled,“CollectivitiesKens but ingrassrootscommunitypractice. read throughout thiszine,isrooted,not inmetaphor, non-profits and themainstreammedia, butasyouwill harm reduction,atermthatoftengetsco-optedby It iswiththisinmindthatIhavealsocometounderstand to thesystemswelivewithin. The responsibilityofmeetingourmaterialneedsistied shoulders ofthemarginalizedand criminalized. the burdenofsystems,lackaccess,andpovertyon drugs, and as anHIV+person,Iknowhowstigmaplaces It isalsofrommyeverydaylife.Assomeonewhouses my expertise. It isfromtheplaceoflivedexperiencethatIdraw understanding ofhowBlackpeoplearepoliced. generationally and continues itsoppressivecontrol This systemofracialized capitalismhasengulfed us board and murdered atseaduringthemiddlepassage.
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INTRODUCTION 11 ABDUL-ALIY A. MUHAMMAD made upof people“impacted bytheHIVcrisis,who have She goesontodiscuss BronxMóvil,acollectivesheisin to reach.” and communitiesoftenmarginalized deemedhard communities; infact,theyarepartofthe fabricofBIPOC by devastationthrive:“Mutualaid networks existinour points tothebalmthathelpscommunities impacted educator andharmreductionistTamara Oyola-Santiago, other. Inhercontributiontothezine,public health Harm reductioniswhatwedowitheachother,for families. the COVID-19pandemichascrushedcommunitiesand Brown andIndigenouscommunitieshavedealtwithas 2020. Thiscoupledwiththeoutsized death thatBlack, for BlackPhiladelphiansinthefirstthreequarters of In myowncityIseethis.Fataloverdosesincreased 40% pain anddiscomfortjustforthesakeofmoralism. will continuetolosepeoplewhoaretakingcareoftheir treatment andothercriticalsocialservices.Otherwisewe engage withsubstancesthatallowforaccesstomedical future. Thereshouldbesaferspacestoconsumeand is oftenwhatallowsustopressonandliveintothe The useofmedicinesorsubstancestocareforourselves people, manyofusseekingrelieffrompainandagony. global hegemony.Thissystemputs unduepressureon This nationunderGod(yeahright)hasmorphed into found itsutilityinjustifyingthesystemofslavery. today. Thisboxinginofpeople,categorizingeachrace, INTRODUCTION 12 ABDUL-ALIY A. MUHAMMAD these tabooedofferings,likefood,can mean thediffer place cleanworksand needles inourbackpacks,for Let ushold each other,and put naloxone inourpockets, with yourcommunity. information. Pleasetakeyourtime,divein,and share many ofthecontributionscontainingresourcesformore images, andreprintsaboutdrugs,sex,activism,with Through outthiszine,youwillfindessays,casestudies, workers, peoplewhoinjectdrugs,andactivists. is usthatbuild solidaritybetweencommunities ofsex food and water. Itisusthatmaskupatprotests,andit understand that acleanneedleisasvital forourlivesas each otheraboutinternalandexternalcondoms,usthat and now,COVID-19.Itisusthathandout educate through AIDS,theWarOnDrugs,massincarceration, are alwaystheexperts,andcollectivelyweseeeachother In readingaboutTamara’swork,Iamreminded that we food, water,socks,juice,PPE.” one, harmreductionbags,safersmokingkits,syringes, Together, theytravelthroughouttheBronxwithnalox who arePuertoRican,Bronxresidents,Queer,migrants.” who usedrugs,haveexperiencedhomelessness, lost lovedonestoHIVandtheopioidoverdosecrisis, system, and that system wantsusdead. the rockyouthrow,isultimatelythatbelonging tothe ence betweennourishmentand death. Judgenotfor - - ↝ INTRODUCTION 13 ABDUL-ALIY A. MUHAMMAD BIO ZINES ARTICLES BOOKS on Twitterat @mxabdulaliy. and nonbinary andgrewupinaworking classBlackfamily.Find them tance ofbodily autonomy,andcenter Blackness.Theyidentify as queer work, theyoftenproblematize medicalsurveillance,discusstheimpor hoking. Acofounderofthe BlackandBrownWorkersCo-op.Intheir Philadelphia, theunceded landoftheLenniLenapepeople,Lenape- Abdul-Aliy isapoztroublemaker, writerandorganizerwhoisrootedin “The YoungInjectables from ParkdaleWomen’sLeadershipGroup Harm Reduction:Howtopreventandrespondan opioidoverdose SEX WORKERZINEPROJECT SWARM BLOCKED: Asexworker’sguidetostalkingandharassment Three HarmReductionZines STRIDE ZINEfromSt.JamesInfirmary Resources, NextDistro Drug UserUnion,NextDistro health disparity,ManuelCano,CamilaGelpí-Acosta Drug overdosemortalityamongstatesidePuertoRicans:Evidenceofa Caitlin White Progress AgainsttheOpioidEpidemicIsNotReachingBlackAmericans, Residents SinceCOVID-19,PennMedicineNews Opiate OverdosesSpikeinBlackPhiladelphians,ButDropWhite Drug OverdoseData,CentersforDiseaseControl by Abdul-AliyMuhammad Coronavirus, likepastpandemics,showshowblackbodiesarepolitical, David Farber,CambridgeUniversityPress,2019 Crack: RockCocaine,StreetCapitalism,andtheDecadeofGreed LaShawn Harris,UniversityofIllinoisPress,2016 City’s UndergroundEconomy Sex Workers,Psychics,andNumbersRunners:BlackWomeninNewYork Dr. KarlL.Hart,PenguinBooks,2021 Drug UseforGrown-Ups:Chasinglibertyinthelandoffear SOURCES ANDRESOURCES ,” fromVanAsherandU.A.Morrison fromPeopleWhoUseDrugsinDenver , , from
, - REPRINT 14 AIDS ACTION NOW! At the2012InternationalAIDSConferenceinWash HARM REDUCTION=LIFE. stood in frontofthestagewithahuge bannerthatread backs ontheminsterasshespoke,allwhile3activists interrupted herspeechand led the crowd in turningtheir As partoftheirprotest,membersAIDSACTIONNOW! and recommendations. denying scientificevidencewhenimplementingpolicies for herAIDSrelatedbudget cutsandhertrackrecord for protested Canadian MinisterofHealth,LeonaAglukkaq, ington DC,activistsfromToronto’sAIDSACTIONNOW! Harm Reduction=Life AIDS ACTIONNOW! aidsactionnow.org AIDS ACTIONNOW,HarmReduction =Life,2012 - ↝ REPRINT 15 AIDS ACTION NOW! Click heretowatchavideooftheprotest. saving activism. printed t-shirts thattheythensoldtofund more life ACTION NOW!Theyused it infutureactions,and even Silence =Death,becameasuccessfulemblemforAIDS This slogan,aremixofthe1986/87poster, AIDS ACTIONNOWproteststheCanadianMinisterofHealth,2012
CASE STUDY 16 THEODORE (ted) KERR Needle Exchange + Jon Stuen-Parker Junkie Union + for WhatWould anHIVDoula Do? Theodore (ted)Kerr CASE STUDY
CASE STUDY 17 THEODORE (ted) KERR rather itwasthestateandsociallysponsored discrimina who dodrugswasnotwhatneededintervention perse, a collectiveunderstanding:individualbehaviorbypeople ideals ofhealthand independence. From thereemerged seen assickand needy inaculturethat valued specific and sharestoriesaboutthedamagingimpactsofbeing ness, theunionsweresiteswherepeoplecouldgather isolation thatmanyuserscultivateforsafetyand well In contrasttotreatmentcentersandtheself-imposed eventually acrossEurope,unionsofdrugusersformed. In theyearsbeforeHIVhitinNetherlands,and use drugs. and “criminal”emergedathirdway,ledbypeoplewho Out ofthisambivalencebetweentherole“patient” Gemma Blok. many ofthemwereleftuncared for,” writesresearcher if welookattheactualtreatmentaddicts received, of nationaland local policybythemid1970s.However, was apatient,notcriminal,had become thefoundation confused, tosaytheleast.“Thenotionthataddict people whoinjecteddrugsintheNetherlandswas In thelate1970s,stateand societal responseto people whousedrugs withrespectandsupport,rather Their thirdwaywas treatment. Specifically,treating and how where theycouldconsumedrugs. and work,withwhomtheycouldmake community, aspect oftheirlives.Thisincluded where theycould live tion theywereexposedtothatnegativelyimpacted every
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- CASE STUDY 18 THEODORE (ted) KERR counselling and educational outreach. Thecitygovern condoms, and the exchangecreatedopportunitiesfor traded in.Alongwiththecleanset,people wereoffered sterile needleand syringe foreveryusedpairsomeone a dealwiththecityinwhichtheywereabletooffer macy incidentwasabouttounfold,theunionbrokered ment. Withthesethingsinplace,bythetimephar and afunctioningrelationshipwiththemunicipalgovern nity, includingacitycenterbuildingthatoffered services amassed whattheyneeded to beofuse totheircommu Formed inthelate1970s,JunkieUnionhadquickly hepatitis B. increase sharing,whichcouldresultinanoutbreakof The Unionfearedthatanequipment shortage would was haltingthesaleofinexpensiveneedlesand syringes. pharmacy, popularwithmembersand other users, In 1984,membersoftheJunkieUnionheardthata In othercases,ittookinnovation. less iftheywereusing,orpeer-runmethadoneclinics. provided safeplaceswherepeoplecouldcrashregard as thecreationofcommunity-runnightsheltersthat treatment looked like improvingexistingservices,such at thecoreofNetherland’sresponse.Insomecases than focusingoncureand abstinence, whichhadbeen and wisdomtolisten tothecommunity.Accordingone nity’s trust,butalso thelocalgovernment’swillingness result ofJunkieUnion’s work,and the drugusercommu care ofthedisposalusedequipment. Thiswasa ment providedthenewneedlesand syringes, andtook
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CASE STUDY 19 THEODORE (ted) KERR In lessthanadecade, Stuen-Parkeramassed over 27 met withsupport.In theUS,theyweremetwithlaw. In theNetherlands,needleexchangepractitioners were when hewasincollegeNewHaven,CT. heroin user,whobegandistributing sterileneedlesback founder wasJonStuen-Parker,aformer Yalestudentand exchange inPhiladelphia,Boston,and New York.The formed, avolunteer-basedorganizationthatdid needle to persevere.In1985,theNationalAIDSBrigadewas In thefaceofopposition,peoplewhousedrugsworked AIDS pandemic: exchange intheUSalmostadecadeandhalfinto summed uptheopposingforcesaroundneedle Noel A.Coutinho,apublic healthofficialinAmsterdam, power and other localoppositiongotintheway.In1995, officials wereamenabletoneedleexchange,federal is adifferentstory.Whilesomelocalgovernmentsand The adoptionofneedleexchangeintheUS,course, were traded out bytheJunkieUnion. researcher, in1985over100,000needlesandsyringes users andthatinterventionshouldstartnow. mented. SupportersstressthatHIVisspreadingfastamonginjectiondrug the effectivenessofsyringeexchangebeforesuchprogramsareimple possession andsaleofillicitdrugs.Opponentsdemanddefiniteprooffor not compatiblewiththepolicyofplacingstrictcriminalpenaltieson programs asanendorsementofillicitdruguseingeneralandtherefore an increaseinthenumberofillicit-druginjectors.Othersregardthese Some fearthatthewideravailabilityofinjectionequipmentwillleadto - CASE STUDY 20 THEODORE (ted) KERR a focusedserviceto help people consumedrugs,anda may obscure,though, isthatneedleexchangeboth did (anddo)savelives.Whatthiswell-earned praise the AIDSepidemic.Andforgoodreason—clean needles credit thepracticeasavitaltacticin earlydaysof Often whenpeopletalkaboutneedleexchange, itisto bucket forthedisposalofusedworks.” than acurbsidetable,cacheofsterileneedles,and a outfits thatMcLeandescribesasoftenbeing“littlemore to thepeoplemakingithappen.Thesewereintimate elsewhere, oftenatgreatemotionaland economic cost in Portland,Tacoma,LosAngeles,SanFranciscoand dor. Bytheearly1990s,needleexchangewasavailable exchange started happening beyond the eastcoastcorri Over time,evenwithgovernmentalopposition,needle acts ofcivildisobedience.” abandoned drug users,publicizingtheir causethrough actively soughttocontestapoliticsthatexcluded and justice, manyofthefirstneedleexchangepractitioners writes: “Citinganethicsbasedinpragmatismand social also somethingofatactic.ScholarKatherineMcLean not ideal,forACTUPandpeoplelikeStuen-Parker,itwas While beingensnared in thecriminaljusticesystemwas Lower EastSide. were broughtinforexchangingneedlesonManhattan’s ing a1991arrestwithothermembersofACTUPwho harm reductionrelatedarrestsinvariousstates,includ - - ↝ CASE STUDY 21 THEODORE (ted) KERR HELPFUL TERMS both elements. is thesystem.Goodharmreduction practicesaddress may posearisk,themostintensethreattotheirsafety who dodrugsnowunderstandisthatwhiledoing What druguserunionmembersinthepastandpeople peers, friends,and community. point ofhumancontactthatoffersanetworksupport, (source: HarmReduction.org) 400 SSPsintheU.S,butmany areasstilldon’thaveaccess. use supplies,andeducation topeoplewhoinjectdrugs.Thereareover Syringe serviceprograms (SSPs) are illegalacrosstheentirety oftheUnitedStates. legal andopenacrossCanada,EuropeAustralia. Atpresent,they intervene incaseofanoverdose.SafeConsumption Sitesarecurrently who areoftentrainedtolinkrelevanthealthand socialservices,and the supervisionofprofessions,volunteersand/ormutual aidworkers, are spacesthatallowfortheconsumptionofpreordained drugsunder Safe ConsumptionSites(oftencalledOverdose PreventionSites) Hannah Gold,N+1,2021 Bold Fury:TheoverdosecrisisandACTUP’sneedle exchangelegacy Noel A.Coutinho,AmericanJournalofPublicHealth,November1995 Annotation: NeedleExchangePrograms-DoTheyWork? Katherine McLean,CritPublicHealth,2011 The BiopoliticsofNeedleExchangeintheUnitedStates Dont Rhine,X-TRA,2013 Below theSkin:AIDSActivismandArtofCleanNeedlesNow What theneedlessaid of adrug-freesociety The politicsofintoxication.Dutchjunkieunionsfightagainsttheideal (Book Chapter) HARM REDUCTION:NATIONALANDINTERNATIONALPERSPECTIVES Sandra Lane,PeterLurie,BenjaminBowser,JimKahn,DonnaChenin “The ComingofAgeOfNeedleExchange:AHistorythrough1993”by SOURCES ANDRESOURCES , 1975-1990,GemmaBlok,2011, , byJohnCurtis,YaleMedicine,2001 distributesterilesyringes, saferdrug , ,
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ESSAY 22 TAMARA OYOLA-SANTIAGO Communities of Drug Use Tamara Oyola-Santiago @bronxmovil
ESSAY 23 TAMARA OYOLA-SANTIAGO share whatwewere beinggiven. in. Thenetworks,lafamilia,grew.Andwe didourbestto organizers, and other harmreductionorganizationsflew churches, sewingcollectives,community partnersand syringes, food,water,socks,juice,PPE. The donationsvia with naloxone,harmreduction bags,safersmokingkits, Rican, Bronxresidents,Queer, migrants—hitthestreets have experiencedhousinginsecurity,whoarePuerto HIV andtheopioidoverdosecrisis,whousedrugs, impacted by theHIVcrisis,whohave lost loved ones to reach. Andsowe—BronxMóvil,acollectiveofpeople communities oftenmarginalized and deemed hard to are partofthefabricBIPOCandpoverty-impacted aid networks existinourcommunities; infact,they and grewexponentiallyasthemonthspassed.Mutual were alreadythrivinginourcommunitiespre-pandemic innovative inmainstreammediasucharrangements As socialbubbles and pods werebeingnamed as solutions. everyday. Thiswasnotnewstous,and neither werethe services sectorwasbeingfullyrevealedmoreand COVID-19 pandemic,andthefragilityofcity’ssocial was alreadyincrisisthemiddle ofthefirstwave was aweekbeforeGeorgeFloyd’sdeath,NewYorkCity thanked uswiththatsentimentonenightinMay2020.It harm reductionsupplies, aparticipantwelcomed and a shelterinupperManhattanaswedistributed food and “Harm Reductiononthestreets?Loveislove.”Infrontof ESSAY 24 TAMARA OYOLA-SANTIAGO not enoughsyringesavailableforbasicharmreduction: production wasalsodiverted,becausethereweresimply ment. Theimpactwasfeltdeeply.Weassumesyringe to personalprotectiveequipmentand vaccine develop Resources, funding,andproduction lines transitioned novel coronavirus. enced asaviolentone,wasalsonowpetridishofthe were being“pushedinto,”whichwasalreadyexperi participants understoodthatthesheltersystemthey kitchens becamegrab and goswithmeal bags.Our appointments werecancelledandsomecommunity ongoing medication-assistedtreatment.Also,medical case management,noHIVorHepCtesting,and limited was nowaterforbathingordrinkinglaundry, services meantthatamidahistoricpandemic,there impacted workforce and many closed as well.Limited are unsheltered and unhoused were grappling withan organizations attheforefrontofservicesforpeoplewho sential businesses toclose;harmreductionnonprofit Cuomo ordered residents tostayhomeandallnon-es Previously onMarch20th,NewYorkGovernorAndrew migrants; peoplewho usedrugsand/orareexperiencing ers; Black,Indigenousandpeopleofcolor; PuertoRican; New Yorkers. Our participants—almost all Spanish speak down overnight;thiswasadefactoeviction formany If thatwasnotenough,inearlyMaythe subwaysshut a newsyringeforeachand every shot. - - -
- ↝ ESSAY 25 TAMARA OYOLA-SANTIAGO BIO Unmasked: ImpactsofPandemicPolicing Overdose DeathsContinuedClimbin2020 loved. Solidarityiscommunity. Housing isahumanright.Peoplewhousedrugsare reduction mustbe24/7.Thewarondrugsend. that isradicallove:Inthecityneversleeps,harm people intoreturningtonormal,wereiterateourvision Now, asvaccinesaremobilized,andcapitalismgaslights streets. Butthiswasawholenewlevelofvulnerability. housing insecurity—alreadyknewhowtosurvivethe co-founder ofBronxMóvilwhereradicalloveand hope humanize. tionist navigatingthemultiplicitiesofhome,justice andhealing.Sheis Tamara Oyola-Santiagoisapublichealtheducator andharmreduc Click criminalization inthecontextofcoronaviruspandemic. A reportthatgathersandexpandsontheimpactsofpolicing inequity reign.Click rates ofmortalityarealsowherestructuralracismandsocioeconomic a reflectionandtheresultofoppression;communitieswithhigher 4th quarter)werehigherthanallof2019.Opioidoverdosedeathis In NYC,confirmeddeathsduring2020(includingsomeinthe Overdose deathscontinuedtoworsenduringtheCOVID-19pandemic. here toread. here toreadmore. SOURCES ANDRESOURCES Dedicado aCabe
- REPRINT 26 BRONX MÓVIL are Bronx-basedand working inthetrenches ofdisrupt our communitiesacrossNewYorkCity(NYC).Mostofus and organizedtoaddresstheopioidoverdosecrisisin collective ofharmreductionistswhoinearly2021met Desenredando laMaraña(UntanglingtheWeave)isa the opioidoverdose crisis willbeworseforPuertoRicans. year markedbyCOVID-19,themorbidity andmortalityof The numbersareterrifyingandwesuspect thatin2020,the in particular,statesidePuertoRicans.Thedatashowsthat: disproportionate impactoncertainLatinxcommunities, demonstrates thattheopioidoverdosecrisishashada Data published in 2019byCanoand Gelpí-Acosta ing anddismantlingthewarondrugs. • The2018drugoverdosemortalityrate washighest • In2018,theage-adjusteddrugoverdosemortalityrate • From2009to2018,theage-adjusteddrugoverdose among PuertoRican-heritagemenages 45-54. non-Latinx whiteindividuals. was significantlyhigherinPuertoRican-heritagethan among womenandnearlytripledmen. mortality rateinstatesidePuertoRicansdoubled Bronx Móvil+ElPuntoenlaMontañaand Desenredando laMaraña (Untangling theWeave) @bronxmovil @nextdistro community activists
- REPRINT 27 BRONX MÓVIL education andaction. and oneoftheepicenterscrisis.Ourpillarsare are centeringPuertoRicansinTheBronx,wherewelive a medicationthatreversesanopioidoverdose.Andwe a playonNarcan,thebrand name for naloxone, And so, DesenredandolaMarañacreated peoples. and supportsovereigntyforindignenouscolonized the warondrugsmustend;andweacknowledge tools—we need to combatgentrification and NIMBY; and socialjustice.Wecannotjustprovidepublichealth reduction thatempowersandtransformstowardsequity health promotionprograms.Anotherthreadisharm and culturalcenteredness (goingbeyondappropriate) that willthenhelpshapespecificlanguage(vocabulary) nities. As harm reductionists on the streets, we need data of thetermLatinxhidesrealdataaboutspecificcommu Although itstrivesforgenderdiversity,theheterogeneity of categoriesusedinbiomedicineand public health. One thread is languageand the non-specificterminology So whatistheweavecollectiveaimstountangle? empowerment where weendthewarondrugsand Together wehealand weworktowardscommunity center thehumanrights ofpeoplewhousedrugs. including theuseofnaloxone. Get trained and trainothers. Learn harmreduction tools, specifically aboutopioids. Let’s talkaboutdrugs,
Narcanazo,
- REPRINT 28 BRONX MÓVIL revierte lasobredosisysalvavidas.¡Obténlo!Visita dosis deopioides.ElNarcanesunmedicamentoque La comunidadlatinaestámuriendodebidoalasobre #boricuassalvandovidas #narcanazo naloxone.) #reduccióndedaño#lanaloxonasalvavidas happened inNewYork.Let’ssavelives!Learnhowtouse deaths amongPuertoRicansintheUnitedStates vidas! Aprendeausarlanaloxona.(Oneof5overdose Estados UnidossucedióenNuevaYork.¡Vamosasalvar Una decada5muertesporsobredosisentreboricuasen Two ofthesocialmediapostsfolkscanuseare: available foruse. community charlasandnaloxonekitsreadily primas tochurches,botánicasandbodegas.Ourgoalis kinfolk members,fromlovers,padres,madrinasand talking withourneighbors,localbusinessleadersand Spanish. Wearecanvassingourneighborhoodsand We createdpostersandasocialmediacampaignin #latinxssalvandovidas #narcanazo #reduccióndedaño #lanaloxonasalvavidas @nextdistro. Wewilltrainanddeliverthe Narcantoyou.) dose and saves lives.Getit!Visit@bronxmoviland overdoses. Narcanisamedicationthat reverses over el Narcan.(TheLatinxcommunityisdying duetoopioid @bronxmovil [email protected]
- - ↝ REPRINT 29 BRONX MÓVIL Bronx Móvil+ElPuntoen laMontañaandcommunityactivists, Bronx Móvil+ElPuntoenlaMontañaandcommunityactivists, Desenredando laMaraña(unodecadacinco) Desenredando laMaraña(Naloxona) , 2021 , 2021 REPRINT 30 JODI BOSIN See theinfographicfordetails.CarryNarcan;it’seasy! to nocostsimplybystoppinginatyourlocalpharmacy. York andamajorityofotherstatescangetNarcanforlittle thanks toastandingorderprescription,residentsofNew to harmreductionandoverdoseprevention.Additionally, service agenciesthroughoutthestatethatarecommitted Narcan (naloxone)isavailablefreeofcostatmanysocial 1 order) prescription.order) (standing specific non patient recipient through a opioid antagonist (Narcan) to an antagonist dispense anopioid pharmacist may In NYC a NYS PUBLIC HEALTH LAW dispense Narcan. standing order to chains have a and allmajor Most pharmacies https://www.health.ny.gov/diseases/aids/general/opioid_overdose_prevention/docs/pharmacy_directory.pdf Pharmacies with astanding orderinNewYork state: 2. . Introduction byDavidOscarHarvey How ToGetNarcan Infographic byJodiBosin 3. approximately $30 approximately www.GoodRx.com fromcoupon $150, a with but nasal Narcan costs insurance, Without ARTICLE ,ARTICLE SECTION TITLE save lives. and can legal 100% Narcan iscarrying Owning and Narcan. of theof cost orall cover most insurance will Medical 4. @jodi_bosin Jodi Bosin,HowToGetNarcan, 2021 I P L F N G S E O R H E A
O C T A R A A T M Y C R S I L A M N Y N ! O G A U BII C R Y
↝ REPRINT 31 JODI BOSIN HELPFUL TERMS opioid relateddeaths. US haveastandingorderrelatedtonaloxonehelpstoppreventable tion thatcoversalargegroupofpeople.Rightnow,manystatesinthe prescribing privileges,includingastatehealthofficer,writesprescrip Standing Orderisamechanismbywhichhealthcareproviderwith (source: Narcan.com) problems andseveresleepinessornotbeingabletorespond. or suspectedopioidoverdoseemergencywithsignsofbreathing Narcan isaprescriptionmedicineusedforthetreatmentofknown (source: HarmReduction.org) of anoverdoseandtostopwhileit’shappening. who lovepeopleusedrugs,withinformationtomitigatetherisk overdose. Weaimtosupportpeoplewhousedrugs,andthe offers evidence-basedstrategiesthatreducetheriskofdyingfroman day. Thatequals70,000avoidabledeathseveryyear.HarmReduction people fromdyingdrugs.190dieanoverdoseevery Overdose deathsarepreventable.Wehavethetoolsweneedtostop is notresponsivetostimulationand/orbreathinginadequate. a combinationofopioidsandotherdrugsinthebodythatvictim drugs. Opioidoverdoseshappenwhentherearesomanyopioidsor on lotsofthings,includingalcohol,Tylenol,opioidsoramixture combination ofdrugsoverwhelmsthebody.Peoplecanoverdose potency. Overdose(OD)happenswhenatoxicamountofdrug,or without knowledgewhileothersuseitintentionallybecauseofits a smallamountgoeslongway.Manyindividualsconsumefentanyl heroin. Peopleusefentanylbecauseitischeaptomanufactureand Fentanyl isasyntheticopioidthatabout50timesaspotent SOURCES ANDRESOURCES Find outwhatisgoingoninyourstate.
- ESSAY 32 DAVID OSCAR HARVEY Collectivities in Kensington David OscarHarvey @DavidOscarHarvy
ESSAY 33 DAVID OSCAR HARVEY oasis ofcreativityand camaraderiefor4+years,was dearly heldresources. Alocalcommunityartstudio,an against ravenousNIMBYforcesencroaching uponour mobile clinic.Itisintheeffortsoforganized resistance care, loungingandsmokingonfoldingchairs outsidethe the easycollegialityofparticipantswaiting forwound in ourbackpacksarelikepledgestoallegiance. Itisin overdoses, againsttherarityofafatality. TheNarcans unpredictably and everywhere. Itisin theubiquityof of collectivitythatstand out. Here,community manifests dotting theKensingtonlandscape,butitismoments It wouldbeobscurantisttodenytheagoniesofisolation market ontheEasternseaboard. opioid users aswellthemostprolific openairdrug contains thenation’shighestconcentrationofhouseless Point isintheKensingtonsectionofPhiladelphia, which largest harmreductionsocialservicesagency.Prevention my workatPreventionPointPhiladelphia, Pennsylvania’s and collectivitybothinmyhistoryasadruguser I myselfhavefeltthevacillatingpullbetweenisolation other, weoftenexperiencesolitudewithoutremorse. family, conventionalsocialstructures,andindeed each the warondrugs,whichalienatesusfromfriendsand solitude andcollectively.Thankstothemercilesslogicof drugs experiencelifebetweenextremesituationsof Philosopher FelixGuattariwrotethatpeoplewhouse “They areus;wethem.” —Prevention Point ESSAY 34 DAVID OSCAR HARVEY nested inthebehavioritself,subjects ofharmreduc From myworkandlife,Icantellyou:Beforetheharm of harmexponentially. ured bystigma.Thissaturationredoublesthepotential disapproval; foractivitiesengorgedwithandthusdisfig for behaviorsthatbearthemarkofsupremesocial figured asharmreduction. Harmreduction isreserved a seatbeltandbrushingyourteetharen’tcommonly eating sugaryfoodsbeartheriskofinjury,yetwearing “casual” sex,sexwork,anddruguse.Drivingcars always behaviorthatispoliced and moralized; namely this definitionisinsufficient.Harmreductionnearly that mitigateharmwithin“risky”behaviors.However, is harmreduction?Classically,itdefinedasactivities the onescommonlycited.Let’sbacktrackabit:what tion. Yettheharmsmostinneedofreduction aren’t The activitieslistedaboveareexamplesofharmreduc lot (“thelovelot”)afewblocksaway. closure andtheupstartartstudionowheldinaparking zoning laws.Collectivityisthepicketsignsprotestingits recently closeddue toanarcaneinterpretationoflocal those whocareforthem inKensingtonmustreduce the materials. Thecommunity ofpeoplewhousedrugsand than, say,theabscessesthatfollow reuseofinjection fold ways,but itsexistenceisabstractand far lessvisible LGBTQ+ folksandBIPOC.Theinjuryshows upinmani stigma, beingmarginal;asocialliability compounded for tion contend with theinjuryofexistingapart,bearing - - - - ESSAY 35 DAVID OSCAR HARVEY care and love ofour ownselves.Resistideologythat denying usfromthe comfortofothersandindeed the narrative, foritbearsthedangerofcohering withinus, is theonemostoftenbeingtold.Wemust resistthis War onDrugs.Alienationisnotthewhole story,butit drivel gliblytraffickingintheopticalunconscious ofthe But itispropaganda,nothingbutsensationalist, inhuman photography” ofKensingtonreplicatesthis impression. as joyless,alone,withoutsolace.Indeed,most“street imaginary would have usconsiderpeople whousedrugs We faceacrisisofrepresentation.Themainstream transmogrified intoaperversetypeof(“tough”)love? activities ofshunningand punishment aresomehow Imagine beingasubjectsostigmatizedthathateful on ourselves. Institutions hurtusfarworsethananypainwebring hostile toit;itisthefalloutofWaronDrugs. policies atbestindifferenttoourwell-beingandworst yielded bytheirownbehavior;itisbornofgovernment down uponthesubjectsofharmreductionisnotpain examples canfillabook.Mostofthehurthammered the lackofhousingoptionsforpeoplewhouse.The with thementalhealthstrainofbeingmarginalized, employment affordedtofolkswithacriminalhistory, a safedrugsupply, oftheforeclosurelifesustaining mortar syringeexchange,ofthecold,cruelrefusal harm oflivinginalargecitythatonlyhasonebrickand
↝ ESSAY 36 DAVID OSCAR HARVEY BIO Don’t lookatuswithharminyoureyes. fied bythestubbornlogicofaprohibitionistperspective. these areeverywhere.Thosewhodonotseeitstupi out. Imagineacommunity.care.InKensington, frozen andincapableofcomingtogetherreaching encrypts peoplewhousedrugsinaplasterofstigma, David OscarHarveyisaharmreductiontherapistinPhiladelphia,PA. The Stairs,directedbyHughGibson(2016) October 29,2019 of HIV,butFentanylMeansCasesareUp Aubrey Whelan,“ Philadelphia (2009) Robert PFairbanksII, (2021) Dr. CarlL.Hart,DrugUseforGrown-Ups:ChasingLibertyinaLandofFear Use,” FilterMag,January31,2020 Stanton Peele,“ Dedicated toKevinMurphy(1983–2020) Beyond HarmReduction:EncouragingPositiveDrug Philly’s NeedleExchangePrevented10,000Diagnoses SOURCES ANDRESOURCES How ItWorks:RecoveryCitizensinPost-Welfare ,” PhiladelphiaInquirer, -
REPRINT 37 ABDUL-ALIY A. MUHAMMAD Muhammad inthisop-edforThePhiladelphiaInquirer, “Black peopleareusingopioidstoo,”writesAbdul-AliyA. Over thelastfewweeks,debatehasraged overSafe experience withit. encounter otherblackpeoplearoundmy agewhohad barbiturates withcodeinecoughsyrup. Iwould go onto I didlearnthatday“pancakesand syrup” could mean small containerofcoughsyrup.WhileIdidn’tpartake, piece ofaluminumfoilcontainingtworoundpillsand a so Ithought.Shecamebackinsteadwithawrinkled on Diamond Street asshewenttoget thepancakes— drive hertoNorthPhillypickitup.Iwaited in thecar syrup at11p.m.Greedyforbreakfastfood,Ipromised to A friend asked if Iwanted to joinherforpancakesand black Philadelphianusingpainmedicationrecreationally. When Iwas17,witnessed,forthefirsttime,another that noonegetsleftbehind. a reminderthatpartof“doula-ingthesystem”isensuring plans when communitymembers pushed back. open asiteinSouth Phillywithinaweek,butcanceled opioids. InlateFebruary, thegroupannounceditwould tion siteinPhiladelphia topreventoverdosedeathsfrom house, thenonprofittryingtoopenasupervised injec not justa‘white’problem Abdul-Aliy A.Muhammad for Opioid crisisisstill The PhiladelphiaInquirer @PhillyInquirer @mxabdulaliy
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REPRINT 38 ABDUL-ALIY A. MUHAMMAD for crimeanddruguseduringtheera, hyper-incar know therest:Federallawmakersintensifiedpenalties than dealerswhosold powdered cocaine. Manyofus and usingcrackcocaine,oftengivenharshersentences opioid crisis. Blackpeoplewerecriminalized forselling not metwiththesameconcernand humanity asthe It’s infactwell-documentedthatthecrackepidemicwas the wayopioidepidemicisviewedtoday. nal problemsratherthanapublichealthproblem, later thatcrackuseand addiction weretreatedascrimi height, in1990.Philadelphiaofficialsadmitted decades homicides inthecitypeakedat605duringepidemic’s devastation hellbentonkillingtheblackbody,asannual stifled bydrugs.Myfamilyandneighborssawcloseupa survival, painedaddiction,and the povertyoffamilies haunted bythecrackepidemic.Igotaneducationin and politicalconsciousness,Ilived in aPhiladelphia point, andbeforeSafehouseentered our city’ssocial around drugsinPhilly.Longbeforeopioidshitcrisis I remembergrowingup amid a verydifferentconflict that be,while blackandbrown people’ssuffering willbe people willmorelikely getaresponsefromthesystems granted primarilyto whitepeople.Acrisisamong The truthisthatina racializedsociety,humanityis safe consumptionsiteforcrackin1994? Absolutelynot. Americans. CanyouimagineMayorEd Rendell backinga by opioids,whichhavedisproportionately affectedwhite see todaytacklingtheoverdosesand devastation caused editorials, funded campaigns, and political supportwe ceration ensued.Thatisastarkcontrasttothemany
- - ↝ REPRINT 39 ABDUL-ALIY A. MUHAMMAD Safe consumptionsitesareapathwaytosavelives. does nothingtostemthethousandsofoverdosedeaths. communities isn’tworking,exclaiming“no”toSafehouse violence intheblackcommunitywithouttrulyprotecting without actuallyreducing homicides. Just asdecryinggun its handsoverpoliticallyexpedienttopicslikeviolence Our cityshould respond to allblackdeath,notjustwring is morecomplicated. drug use.Buttherealityofsavinglives,foranyrace, will disavowanythingotherthancompletelyeradicating Within thecommunitiesIgrewupin,knowpeoplewho than homicides. opioid overdoses werekillingmoreblackPhiladelphians them. AsTheInquirer reported in 2019,asofthatyear, people areusingopioidstoo.They’realsodyingfrom But thatrageignoreswhatIlearnedatage17:Black safe consumptionsites. rightfully embeddedintheragecommunitiesfeeltoward seen astertiaryordismissedwholesale.Thisdisparityis Visit ThePhiladelphia Inquirer alike, togethertobuild a pathforward. We mustworktobringcommunities,users and nonusers particular riskforLGBTQusers. meth—whose usehasrecentlyspiked in Phillyand is a tion forotherdrugs,suchasstimulants—like crystal More mustbedone,includingexploring safeconsump formorewriting from Abdul-Aliy A.Muhammad .
- REPRINT 40 VOCAL-NY hepatitis C,thedrugwar,homelessness,andmassincarcer power amonglow-incomepeopleaffectedbyHIV/AIDS, statewide grassrootsmembershiporganizationthatbuilds VOCAL–NY (VoicesOfCommunityActivists&Leaders)isa their accomplishments. tion aboutdecriminalization.LearnmoreVOCALand the warondrugs.Below,VOCALoutlinesimportantinforma Union, whichuniteslow-incomepeopledirectlyaffectedby VOCAL–NY’s drugpolicyworkiscarriedoutbytheirUsers to careandsupport,notstigmatizationcriminalization. riencing problematicdruguse,thentheyshouldhaveaccess treated withdignityandrespect.Andthatifapersonisexpe VOCAL–NY believesthatpeoplewhousedrugsshouldbe ation inordertocreatehealthyandjustcommunities. Decriminalization does notequateto legalization. Voices OfCommunity Activists&Leaders(VOCAL–NY) • Drugdecriminalizationwouldremove thethreatof • Thegoalofshiftingawayfromcriminalization toa struggling withdrug use. and increaseservices andaccesstocareforpeople arrest fordruguseand possession ofsmallquantities, and safetytocommunities. reduce theharmsofcriminalization,and offer care health-based approachfordrugpossession isto Decriminalization vs.Legalization: What YouNeedtoKnow
vocal-ny.org
- - - REPRINT 41 VOCAL-NY amount of peopleaccessingtreatment. rather, itcan reduce overdosedeathsandincreasethe Decriminalization will nottriggerdrugusetoskyrocket, • TheCDCjustreleasedpreliminarydata for2020 • Meanwhile,incarcerationincreasestheriskof • Portugal,whichdecriminalized all drugs in2001, • Decriminalizationhasseveralpublic healthand racial • Mostformsofdecriminalizationchangecriminal showing thatoverdosedeathsareatrecord levels, released fromjailorprison. for peoplewithasubstanceusedisorder whoare overdose death,anditistheleadingcauseofdeath York Timesanalysis. 100,000 whenthepolicybegan,accordingtoaNew only about25,000Portugueseuseheroin—downfrom tion alsoplummeted.TheHealthMinistryestimated 24-year-old population”andtherateofHIV/AIDSinfec has seendruguse“declinedoverallamongthe15-to the numberofpeoplearrestedand incarcerated. decriminalized, there’sbeenanassociated decrease in justice benefits.Inplaceswheredrugshavebeen services --notforcethemintojail. pay afineand/orconnectwithtreatmentandsocial a non-criminalviolation(aticket),makingdrugusers penalties forpossessionofsmallquantities ofdrugsto year forthelasttwodecades. and lastyear’sspikeindeathsarehigher thanany
- ↝ REPRINT 42 VOCAL-NY interaction with thecriminal-legalsystem. penalization of BlackandBrown people andtheir Decriminalization would addressthedisproportionate • In2018,thereweremorethan1.6milliondrugarrests • In2019,morethan45%ofpeoplearrestedorcited • AccordingtotheDrugPolicyAlliance,Blackpeople selling and distribution violations. are forpossessiononly,andmanymoreminor in theUnitedStates.Morethan86%ofthesearrests population. New Yorkersmakingup under 25%of thecity’stotal for drugoffensesinNYCwereBlack,despiteBlack 13% oftheU.S.population. for drugpossessiononly,despitemakingupjust and roughly35%ofthoseincarcerated in stateprison make up29%ofthosearrestedfordruglawviolations ↝ REPRINT 43 SESSI KUWABARA BLANCHARD please consultthemarvelousinfographicbelow! and susceptibilitytoinfections.Forsafestboofingpractices, experience ofitseffects.Boofingstillretainsrisks,likeanaltearing finds itswayintothesystem,leadingtoamoreconcentrated bioavailability. Thatmeansahigherconcentrationofthedrug Compared tootheradministrationroutes,boofinghasahigh lung damageofsmoking. circumvents thenasalirritationfromsnortingandpotential can leadtodebilitatingandevenlethalinfections.Boofingalso drug userisfarlessatrisktoskinconditionslikeabscesses,which can leadtopainfulskinandveindamage.Throughboofing,the through theanus.Peopleboof,ratherthaninject,asinjection Boofing, orbootybumping,isamethodofconsumingdrugs Sessi Kuwabara Blanchard, Infographic bySessiKuwabaraBlanchard Introduction byDavidOscarHarvey Click here toseemore workbySessiKuwabara Blanchard @SessiBlanchard BOOF IT! BOOF IT!Getting HighDownUnder,2021
REPRINT 44 TIFFANY MARRERO contract sheaskspeopletosignbeforetheybecomephysi excerpt fromactivistTiffanyMarrero’sarticleabouta Often thesourceofharmcomesfromstate.Readan Body autonomy?What isthat? laws thatI’veneededtonavigatewhile living withHIV. from ignorantprejudice,old-school rhetoric,and criminal were creatednotoutofmyownpreferences butbirthed My contracts,thoughtheypavetheway tosexand fun, Nope. Notformylife. words and lace—all sofunandalleasy. Right? from analtowatersports,softandhardboundaries,safe name onaneroticdottedlineconsentingtosexualacts— It allseemssosexyinmovies:Asubmissivesignsher it withtheirpermission. perspectives onHIVandrelatedissues.Wehaverepublished delivers vitalinformation,news,support,andpersonal This articlewasoriginallypublishedonTheBody,which cally intimatetoprotectherfromHIVcriminalization. As aWomanWithHIV,IMakeMySex Partners SignaDisclosureContract: Tiffany MarreroforTheBody @theeblackteebrand @TheBodyDotCom Here’s Why
- REPRINT 45 TIFFANY MARRERO words forthefollowing: This contract,fromtoptobottom,containsformalcode keeping thepublic safe. it’s acceptabletopolicemybodyunderthenotionof the law,ignorant,hate-paradefolkswhothink This contractis,inessence,anactofrebellionagainst nights ofbliss,despitelawsthatputwomenatharm. And it issomethingthatsays:Weareworthy ofnicehot this isatleastsomething. we knowthatchangeisslow--and in themeantime, pussies. Althoughthelawsarestartingtochange, women thatwestillhavesomesortofcontrolour equal justice under the law, I hope that mine shows other and weallknowthatthere’ssometimesnoguaranteeof be sureacontractwould be legallyvalidwheretheylive, to keep my vaginasafe.Thougheachpersonneedsto Anyways, backtothecontract:It’sabluntand tactful way • Mypartnersignsonthedottedlinewith understand • Mypartnersignstheirnameacknowledging theywere • Mypartnerconsentstoeatingmyboxandfiddling my • Foranotherrebellious act,Inotethatam me. (DidImentionlovekink?) me oranyoneelsetoswapspitandmaybe blood with not heavilymedicatedorcoercedinany mannerby for thepast25years,livingwithHIV. violin withtheunderstandingthatIam,andhavebeen undetectable. lievers, haveapositive punnany. ing thatI,let’srepeatitonemoretimefor thenonbe
- - ↝ REPRINT 46 TIFFANY MARRERO “laws” thatwerecreatedwithoutthinkingofTiffany... sex withcondoms,whicheverIwant,simplybasedon I, myfriends,willNOTstopenjoyingcondomlesssexor created theirowncontractsandwemadeacontractquilt? the salt-lacedaftermathofmytears?Whatifallpozfolks my blood-stainedfingerprintsonthem?Willtheycarry the injusticeImayhavetoface.Willmycontracts sexual fulfillment.Thiscontractalsogoestoshowyou laws thatrejectand destroy myright to discloseor This contractisapermanentstapleofmydistastefor body, well-awareofmysexypositivestatus.YES! others, haveinfacttastedthejuicessquirted outofmy women, cis,trans,non-binary,black,Latinxand/or Let itbeknownthatmany,manypeople,theymen, other positivesistersneed fear theirorgasms.Nah. believe thatIamindeed afraid ofmysexualityorthat another HIVcriminalizationcase—shouldnotlead you to This “contract”—writtenat2a.m.afterreadingup on Read therestofTiffany’sessayatTheBody in herstateifthereisevenawhisperthat shehadsex. who isnow26andhasthepotentialtoface afelonycharge a babynamedTiffany,whohappenedtobebornwithHIV, .
CASE STUDY 47 THEODORE (ted) KERR How To Have... Safer Sex + Play Fair + What Wouldan HIV DoulaDo? Theodore (ted)Kerrfor CASE STUDY
CASE STUDY 48 THEODORE (ted) KERR everything fromHepatitisandHerpes,toguilt. sex partners.PLAYFAIRalsocontainsSTDdefinitionsfor of caresuchasexchangingnamesandcontactinfowith infections. Includedintheirpreventionrundownareacts “poppers,” toprovidetipsonhowavoid STDs and used culturally specificlanguage,such as“rimming”and Indulgence releasedPLAYFAIR,afold outpamphletthat In 1982,inSanFrancisco,theSistersofPerpetual health andcommunitycareareharmreductionmethods. arguably morenoteworthyintheirassertionthatmental chances ofgettingSTIs,thesehistoricdocumentsare advocating forgaymentousecondomsreducetheir sex life.Whilebothpublicationsareoftenrememberedas and specificprecautionscouldplaytoensureahealthy tive communitiesabouttherolethatmutualaffection communities ofgaymen,queer nuns,andtheirrespec ing, twopamphletsstartedtocirculateamongcostal In theearly1980s,asword of a“gaycancer”wasincreas monia arenowlurking amongus”and defined Kaposi’s acknowledge that“mysterious formsofcancerand pneu While thetermHIV/AIDS isneverused,theSistersdo The SistersofPerpetualIndulgence,excerptfrom PLAY FAIR,1982 - - - CASE STUDY 49 THEODORE (ted) KERR Creative Penetration. includes thesubheadings:CreativeMasturbationand Fucking, GettingFucked,aswellNoRiskSexthat sex actsunderheadingssuchasSucking,GettingSucked, course of40pages,theyrunthroughtherisksvarious How to Have Sex in an Epidemic: One Approach. Over the direction ofJosephSonnabend,releasetheirpamphlet York, RichardBerkowitzandMichaelCallen,underthe Less thanayearlater,in1983,acrossthecountryNew understand as AIDSrelatedopportunistic infections. sarcoma andpneumocystis pneumonia,whichwenow theory”), or2)asaresult ofnumerousSTIexposuresover a resultofvirus,(what theauthorscall“thenewagent definition, outlining theoriesthatunderstand AIDS:1)as use thetermAIDS,althoughittroubles the accepted Unlike PLAYFAIR,HowtoHaveSexinanEpidemic does under thedirectionofJosephSonnabend,excerpt from How toHaveSexinanEpidemic:OneApproach Richard BerkowitzandMichaelCallen, , 1983
↝ CASE STUDY 50 THEODORE (ted) KERR of sexandharmreduction. “safer sex,”and are vitaldocumentsin theongoingstory are theprecursorstowhatwould come tobecalled works likePLAYFAIRand makes clearinchapteroneofherbook,“InfectionIdeas,” that communityplaysinsexualhealth.AsJenniferBrier HIV, theyalsoillustrateinnouncertaintermstherole liberation, forevermovingforward to beconnectedto These documentscapturenotonlyaturningpointingay happened toourgreatgayimaginations?” protection. Hardquestions forhardtimes. Butwhatever Berkowitz andCallenwrite,“Maybeaffectionisourbest to preventahealthcrisis.Insectioncalled“Love,” the meaningofgayliberationasauthorsattempt tone ofPLAYFAIR.Insteaditisearnest,grapplingwith How toHaveSexinanEpidemichasnoneofthecamp unclear, likehowtotestforthevirus. been identified,andmuchremainedunknownor This wasamomentinhistorywhenHIVhad only recently a person’sbody(theycallthis“themultifactorialtheory.”) time resultinginabuild up of cytomegalovirus(CMV)in Sonnabend, Richard BerkowitzandMichaelCallen,underthedirection ofJoseph Responses totheAIDSCrisis and theLegacyofGayLiberation,” from Jennifer Brier,“Affection Is OurBestProtection:EarlyAIDSActivism The SistersofPerpetualIndulgence, How toHaveSexinanEpidemic:OneApproach SOURCES ANDRESOURCES (2009) How toHaveSexinanEpidemic Play Fair Infectious Ideas:U.S.Political , 1982 , 1983 ESSAY 51 MOLLY M. PEARSON My COVID Yum! Don’t YuckDon’t @mollympearson Molly M.Pearson
ESSAY 52 MOLLY M. PEARSON radical compassionthatisinherenttoa harmreduction harm inpursuitofpleasure,andweallbenefitfromthe all facedwiththetaskofassessingriskand mitigating racism, settlercolonialism,and climate change—weare of multiplepandemics—HIV/AIDS,COVID-19,systemic reduction asapractice.Itisactive.real.Inanera make itthatmuchmoreurgentwenameharm Flattened interpretations ofharmreduction likethese of votingwhenpresented with lessthan idealcandidates. “harm reduction”asafigureofspeechtodescribetheact times itisco-opted by well-meaningliberals, whouse sion! MaybeTHEYcan’thelpthemselves,butWEcan!Some over THERE,doingthoseWILDTHINGS,needourcompas almost withanairofsaviorism,asiftosayTHOSEpeople for salaciousassumptionsofsexworkand drug use, Sometimes thephraseisused as ashorthand signifier a vague,cooldistancethatisdivorcedfrompractice. It’s oftenpresented via meme,and sometimes with to thepointwheremeaningofitcangetlost. the phrase“harmreduction” hasbecomeubiquitous, Within theseleftist,activist,and liberationist circles, who genuinelywanttheworldtobeabetterplace. I amluckytobeincommunitywithallsortsofpeople I amaformersexworker, andIkeptahammernextto that havehappened to us.Icanonlyspeakformyself. ing throughthingswehavechosentodo andfromthings tangible practice.Wemayhavecometo thisunderstand Some ofushavelongunderstoodharm reductionasa ist wayofbeinginrelationship with others.
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- - - ESSAY 53 MOLLY M. PEARSON expect. It’sabaffling thingtowitnesssomeonewhom sometimes frompeople withinourcircleswewouldleast exposure hasproliferatedformorethan ayearbynow, been unpopular.Arigid,hardlinestance onCOVID badly need,hasbeenhardtocomeby, or it’satleast The radicalcompassionthatIneed,and thatweallso these masklessmealsareworthittous. is imminentwithorwithoutCOVIDinthepicture,and COVID routinewehavemutuallyagreed upon. Hisdeath hope thatotherswouldbeglad for Paul and me andthe either ofuswerevaccinated.Irelishiteverytime.would across theroomtogether—andyes,wedidthisbefore be withhim,weshed our masksand share mealsfrom Sometimes, whenItraveltomyhometowncareand harm reductionsaveslivesand makes lifebearable. entire generation”toAIDS,andheislivingproofthat HIV negative.Heislivingproofthatwedidnot“losean ago. Whilehemanagesmultiplechronicillnesses,is 72 yearsold,and he cameoutasgay nearly fiftyyears the manwhoraised me aftermyparentsdied.Heis Today, Iamsomeonewhoisacaretaker.careforPaul, the loveandkinshipthatemergesfromHIV illness. died of AIDSbythetimeIwasseven,andraisedin gladly gave.Iamsomeonewhosebiologicalparentsboth accountability check-insfrommyfriends,whichthey to thepointwhereIwanteduseitless,soasked for schedule. Iamsomeonewhoforatimelovedcocaine my bed and keptmyroommateupdated on myclient ESSAY 54 MOLLY M. PEARSON to well-intentioned,but aggressivepostslikethese: nightclub, coffeeshop,and gossipsession.I’mreferring the internethasbecomeourdefactocrowdedbar, has beendeafening,perhapslouderthanusualbecause throughout theCOVID-19pandemic.Theonlineshouting life worthlivinghavebeengaslitonamassivescale Folks whohavelongrelied on harmreduction tomake a flashengageinpublic shamingfor“bad behavior.” tion abouttheirlocalmutualaid network and then in you thoughtknewandunderstoodshareinforma pods, lovers,andfamilies. It’struethatwehavemuchto tion tohelpguideCOVID conversationswithoursocial skills commonly found in pleasure-based sexuality educa have highlightedthebenefitsofusing principles and monolithic, especiallyontheinternet.Several writers Of course,noculturalresponsetoamajor eventis zen-led public serviceannouncements. into aspaceofperniciousvitriolthinlyveiled as citi reshared toapointbeyondmerevirtuesignalling,and across multipleplatforms,likedandretweeted and And so on.Similarpostsandmemeshave beenblasted Zoom Thanksgiving>ICUChristmas.STAYHOME! I amverysadly,andbitterly,goingtoviewmany Please stoppostingthereasoningbehindyour murderously irresponsibleholidaytravel. of myfellowcitizensasmurderers… Stay home.Makebetterchoices. -
- - ESSAY 55 MOLLY M. PEARSON drugs. Nooneisabovetheneedforharm reduction. sometimes mundaneand has nothingtodowithsexand to anyonelivinginabody,evenwhenbodyis COVID hasmadethatplain.Harmreductionisrelevant sex andusedrugs.Tobealiveistonegotiaterisk, should itonlyapply topeoplewhohave transactional survive andmakelifeworthlivingatthesametime.Nor already negotiating,priortoourCOVIDreality,how apply topeoplewhoaresomarginalizedthattheywere ent inaharmreductionist practice.It should notonly We allbenefitfromtheradicalcompassionthatisinher that weneed,want,and deserve. ing risk,mitigatingharm,andpursuing pleasureinways honor andtrustthatfolksinourcommunitiesareassess liberationist possibilitiesinourthinking.Itallowsusto COVID-era yum.Enterharmreduction,whichexpands for otherpeople’schoices;it’sstilltooeasytoyuckothers’ negotiation, but it’sstilltooeasytohold blanket disdain We mayfigureoutourownboundariesthroughpersonal it fallsshortwhenwetrytoapply ittoacommunitylevel. While thisapproachisidealforinterpersonalexchanges, consent, andwhatfeelsgood to eachofusasindividuals. learn fromsexeducators aboutnegotiation,boundaries, pleasure activists. are. Iwantpeoplewhousedrugstobe celebrated as I wantsexworkerstobehonored as thehealersthey No oneisundeservingofcareandcompassion.
- - ↝ ESSAY 56 MOLLY M. PEARSON BIO: too easy. systemic failingsthatmakepleasureelusiveand death power tohelp us focusourragewhereitmustgo:the collective rage.Thepracticeofharmreduction hasthe among usdon’tdeservetobearthebruntofmisplaced those mostvulnerabletocontractingit.Individuals as strongthesocio-politicalactionstakentoprotect A virusisavirus,anditscontainmentonly loved andcaredforregardlessofhowtheygotthere. And I wanteverypersononaventilatoreverywheretobe bly listeningtodiscowhiledoingthedishes. identity, illness,andcommunity.ShecanbefoundinSt.Louis,proba Molly M.Pearsonlovestowrite,talk,share,andlearnaboutsex, in STL,September18,2020 Melissa Meinzer,“ May 5,2011 Mia Mingus,“ tives ofCare,2020 Marty Fink, rial DayataGayCampground M. J.Murphy,“ Forget Burial:HIVKinship,Disability,andQueer/TransNarra Access Intimacy:TheMissingLink Confessions ofaCOVID-19Super-spreader:MyMemo Saint oftheStreets:Dr.PunchSavesSt.Louis SOURCES ANDRESOURCES ,” May28,2020 ,” LeavingEvidence ,” Out , - - - ESSAY 57 NICK MELLOAN-RUIZ Sustainable Safety: I Don’t Need You. A Year of Feeling the Difference the I Want You. Nick Melloan-Ruiz @25centstoplay
ESSAY 58 NICK MELLOAN-RUIZ most selfwhilestillgivingmechancestogrow.Mysurvi expecting tomeetthepersonwhowouldletmebemy next asIconfrontthatmysaladdaysareover.wasn’t all thestepsamidvastglobalshifts.Inowwonderwhat’s I feltlikearealperson,partofsomething,goingthrough When IinvitedyouintomybubbleinSeptemberfeltsafe. time lamentingit. of importancegetsmuddled and you spendfartoomuch in seeingyouagain.”Whenithappenslikethatthelevel sexual-relationship bysimplysaying,“Ihavenointerest niously endingayearslongstanding-appointment- I preferthatoveryour#1hookupdomdaddyunceremo to beginwith. against apillowatduskandyouneverknewtheirname even ifthelasttimetheysawyouyourfacewassmashed numbers youhaddeletedwouldtextjusttocheckin, I missthepandemicmomentwhenold hookups whose the wallalone. I gotadogbecausedidnotwanttolayinbedlookingat I havethe toolsbutdon’tknow howtousethem. My normal istoalwaysbesuspicious anddefensive. relaxed onceIhave achieved mygoalofsafety? space toask:whycan Iallowmyselftofeelsettledand happen? Yourarrivalgavemeareason, structure, andthe the dooryougo.Iamalwaysuncertain: what morecan answer toaquestionwillbeunsatisfying and,viola,out come backfromashowerandyouwon’t behere,ifmy I worryifitissustainable,youwillgrow tired,ifIwill vor’s guiltragesonasIbaskinyourlove, calmlyreading.
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- ↝ ESSAY 59 NICK MELLOAN-RUIZ BIO starring AshleyJudd that Iforgotabout,orhad no inter June and then alltheother90swomen-in-peril movies I’m sogladyousuggestedwewatchCruelIntentionsin certainly beingno,but Iwilltryagain and again. Easton albumwillmakemefeelsafe.Theansweralmost asking myselfifthiscandleorpairofpajamasSheena friends nearand far tellingthemtotake mehome, narrative, sittinginanunfamiliarlivingroom,texting leave. Iwastired of tryingtoinsertmyself intotheir One yearagoIwasatasleepover.keptwantingto hopes you’llstay. bok choysimmersonthestove.Thishomeengineer of headphones up,followedbymeblowingyouasthe followed byaheartyasseatingsession,sharefullday we canaccessdeeplyingrained moments oftrauma, at amoment’snotice.Atleastwearetogether. ing, rageinducing,andreducingustothevergeoftears that I’mfirmlyinthepresentevenifit’stragic,exhaust reading. RightwhenI’msinkingIlookoverandknow on, shiftingthroughmemorieswhileyousitcalmly I’m sorryyouarethepersonputting yearsoftrauma est intobeginwith. focusing onHIV, PopCultureandtheir dog. Nick Melloan-Ruiz isaChicanowriterliving inBloomingtonIndiana Nadiya Hussain’s Cruel Intentions Carly Simon,“ Donna Summer,“Romeo” Hit Paradepodcast, Take MeasIAm final scene Chicken,Brie,Cranberry and PinkPepperPithivier Turn AroundBrightEyespart1 SOURCES ANDRESOURCES ” - - REPRINT 60 WWHIVDD? the ongoingHIVresponse,andasmembersofWWHIVDD, in ordertosurviveandthrive.Harmreductioniscentral communities impactedbyneglect,bias,andstateviolence, who usedrugs,sexworkers,peoplelivingwithHIVandother developed andsharedovertimeinformedbyforpeople Harm reductionisnotametaphor.Itseriesofpractices excerpt fromthatfirst conversationsharedbelow, talk aboutherworkasamidwifeanddoula. Inatranscript to thecreationofWWHIVDD.LodzJoseph used thetermto The term“holdingspace”cametousatthe eventthatled harm reductionpractice? With thatinmind,wehaveaquestion:isholding spacea transition. reduction strategies,andharmcanbeaformof We havecometolearnthatdoulasoftenemployharm continue throughtreatment,andmaylastlongafterdeath. is aseriesoftransitionsthatbeginlongbeforediagnosis, space intimesoftransition,withanunderstandingthatHIV As weoftenstate,thinkadoulaissomeonewhoholds we seeitasvitaltocollectivecareandliberation. she expandsontheterm afterbeingpromptedtosaymore IS HOLDINGSPACEAHARM REDUCTION PRACTICE? What Wouldan HIV DoulaDo? @wwhivdd
REPRINT 61 WWHIVDD? harm reduction? Read below,andtellus,isholdingspaceaformof witnessing, andagainstforgetting. work aheadremain.Theharmreductionhereisanactof for someoneafterastormhaspassedbutthewindsand in thefaceoftrauma,somethingakintoproducingamirror doula assomeonewhohelpspeoplerememberthemselves Additionally, weseehowMichaelfurtherunderstandsa and seeinghowtheharmcanbeeradicated,ordefused. as cultivatingaplacebetweenharmandanindividual, an institution.Holdingspaceinthesesituationscanbeseen a patient’sneeds,whilenavigatingthepeopleandspacesof space” isadoulataskthatrequiresaddressing how“holding Reading LodzandMichaeltogether,onesees ples fromhisworkinhospitals. Michael CrumplerbuildsuponLodz’scomments,withexam by curatorAlexFialho.LaterintheconversationChaplain LODZ JOSEPH:Irememberwhenfirstheardmy ALEX FIALHO:Whenyousay“Holdspace,”howdoes way becauseIknow whatyoumayneedbut youmay and sometimesImake adecisiontotouchcertain phrase isreallyjustaboutobservingwhat isgoingon and IwascrazyTypeAnowamnot. Formethe mentor sayit.Iwaslike,“thishippy.” Igrewup in NYC that happen?
- REPRINT 62 WWHIVDD? MICHAEL CRUMPLER:Wecanbuild offwhatLodzwas don’t lookattheemails,andreferralscome. taking careofmyself.WhenItakemyself me. Thatalsohappens.Ithinkholdingspaceis Not everyclienthasreferred me orran areferralfor client, and you wereholdingspacethe wrongway. about beinghumble-whenyouarenotinsyncforthe also toughwhenyougetyourasshanded to you.Talk way. And that istough.Itcrushingto theegobut with theclient,whenIamproblemandin mom’s way.TherearetimeswhenIamnotinsync And sometimes itisaboutmejustgettingoutofthe messing uptheenergy?” go getmewater?”or“Canyoujustleavecauseare partner, “Ineed you togoonawalkrightnow,can asking yourpartnertoleavetheroom.Iwillsay your partnercanhavetimealone.Sometimesitis it ishugging,massage,leavingtheroomsoyouand not necessarilyknowhowtoarticulateit.Sometimes Usually chaplainsare encouraged by aparticularity. hold spaceinamuch moretraditional,orthodoxway. talking aboutwhen she said holding space.Butwe as thatthirdspace,Iknewexactlywhat shewas chaplaincy. Chaplainsfunctioninhealth carefacilities saying aboutwhatadoulaisand how itrelatesto go home.Thatdoesnotexistinourworld. tired and that youcan’tbethere.But I can’tcallsickor boom, everythingiseasy.Whenyouarenot,feel When youaretakingcareofyourselfitisjusteasier,
REPRINT 63 WWHIVDD? minutes whenIamdonewiththisconversation?” “Can thatwait?Canyougetbloodpressurein10 role ismoreurgentthanprayer,itmyjobtosay, with apatientandnurseordoctor,whothinktheir ethical andmoralauthority.Example:ifIampraying at thesametimeyouaregoingtofunctionasacertain You aregoingtobeoutofthewaynurses,but lain holdsemotionand spiritual experience. sustaining supportisgoingtoberemoved,thechap casualty eventlikeacaraccident,shootingoriflife the humanityofpatient.Sowhetheritisamass A chaplaingoesintoasystemand holds spacefor keeping thatpowerstructureaccountable,youknow? accountable tothatsystem,butalso Whereas thechaplainispartofhealthcaresystem, it soundslikeyouarehiredbythepatienttobethere. be alittledifferent,correctmeifIamwrongLodz,but organizational structureofthehospital.Sothatwould for thepatient,attimes.Yes,theyarepartof beyond thosefaithidentities.Theycometoadvocate Protestant chaplains,Muslimchaplainsand even There areJewishchaplains,Catholic everyone else?” really thinkthenursesdon’tlikeyouand theylike system. SometimesIhavetobelike,”Really, doyou in forthedoctorwhenpatientiscritical ofthe you threetimesforablanket”.Oritcould be standing Or sometimesitis,“Sheiscold,andshe hasasked
- ↝ REPRINT 64 WWHIVDD? Click Later… MICHAEL: WhatIthinkaboutalotisunconscious know. Ithinkadoularemindsyouofwhat I thinkwhatalotofpeopledoisforgetthey is afireallofsuddenyouforgethowtocall911. make youstupid.Youknowwhattodo.It’slikeifthere that Iwasn’tinsane,becomingpositivedoesnot have beenniceisforsomeonetoremindedme what Iknew,lostmyinternalcompass.Whatwould traveled internationally, buttraumamademeforget four yearsinactivedutythemilitary,Ihad already I had already donepastoralcare,Ihad already served I becameHIV+hadgonetocollege, a degree, causes youtoforgetwhatknow...Bythetime realize wehave.Ithinkwhathappenswithtraumaisit competence, Ithinkweallhaveknowledgedon’t here toreadthefullconversation.
CASE STUDY 65 THEODORE (ted) KERR and Support + STAR House What Wouldan HIV DoulaDo? Housing Theodore (ted)Kerrfor CASE STUDY
CASE STUDY 66 THEODORE (ted) KERR As Riverashared with Feinberg: fixed up theelectricity,plumbingand theboiler. HOUSE, abuildinginNYC’sLowerEastSidewherethey Among STAR’sfirstactionswasthecreationofSTAR wrote in2006: Rivera andMarshaJohnsonin1970.AsLeslieFeinberg vestite ActionRevolutionaries(STAR),foundedbySylvia survive andthrive,includingtheworkofStreetTrans nities pushedtothemargins,doingwhattheycan The historyoftheUSisthickwithexamplescommu premature death. survival ofpeoplewithin communitiesmarkedfor systems and states, withtheaimbeingongoing stepped in,interveningagainstbiased and neglectful malnutrition, and lack ofhealthcare,communityleaders community healthclinic.Inthefaceofhomelessness, Panthers’s FreeBreakfastprogramand TheYoungLords Rivera andJohnson’seffortsstandalongside TheBlack It lastedfortwoorthreeyears.” chapter inNewYork,oneChicago,CaliforniaandEngland. There wasalwaysfoodinthehouseandeveryonehadfun.Laterwea the kidsoutinstreetshustling.Theywouldgoandripofffood. We wentoutandhustledthestreets.paidrent.didn’twant “We fedpeopleandclothedpeople.Wekeptthebuildinggoing. time tohelpeachotherandourkids,”Riverastated. the streetsforsustenanceandshelter.“MarshaIjustdecideditwas Both RiveraandJohnsonwerethemselveshomelesshadtohustleon Rivera andJohnsonsawtheneedtoorganizehomelesstransstreetyouth.
- - ↝ CASE STUDY 67 THEODORE (ted) KERR Johnson wereearlyHarmReductionists! about STARHOUSE,andthenumerouswaysRiviera and theongoingworkofSTAR,morepeoplearelearning who continuetoshareRivieraand Johnson’s legacies, binaries. Increasingly,becauseofartistsandactivists ogetic livesagainstthetyrannyofgendernormsand as leaderswhowerethereatStonewallandled unapol after theirdeaths,RiveraandJohnsonareremembered including STARaspartoftherevolution.Today,long remembers BlackPantherPartyleaderHueyNewton The YoungLordsintheirwork,and1971,Rivera Soon afterstartingSTAR,Rivieraand Johnson joined survivors withinabiased,andtoooftencruelsystem. to literallyreducetheharmbeinginflicteduponthemas for thesurvivalandliberationoftheirpeople,working and JohnsonopenedSTARHOUSE,theywerefighting rooted in Liberation.”ItissafetosaythatwhenRivera tionerZoë Dodd defined harmreductionas“anideology Last year,activistand long timeHarmReduction practi Molly Brown inthe Watson, ValeryShuman,James Kowalsky,ElizabethGolembiewski& analysis oftheUSandCanadian open-accessliterature “Housing Firstandharmreduction: arapidreviewanddocument Hanna GarthandAshanté M.Reese,2020 Black FoodMatters:RacialJusticeintheWakeof Justice The YoungLords:ARadicalHistory,byJohannaFernández,2019 Young LordsintheBronx Frederick DouglassOpie,“ World, September24,2006 Leslie Feinberg,“ Street TransvestiteActionRevolutionaries Harm Reduction SOURCES ANDRESOURCES ”, 2014 Feeding theRevolutionin1970s:The , 2017 ,” byDennisP. , editedby ,” Workers - - REPRINT 68 CHARLES RYAN LONG our livelihoods.Let us walkawayfromthismoment more thanlikelytoexploit usand further traumatize aren’t comingtosaveusandiftheydo showup,itis shown uswhatmanyofalreadyknew toowell:they in which(he)liveswithinus.Thismoment intimehas systems and (him)haviors and also address theways declaratively callforthedismantlingof whyte patriarchal transformation andbecoming.Wemust publiclyand combined elements ofloveandrage into machinesof my contributionsistomakeartworksthatharnessthe into ourwhat’spossible?togetthejob done. Oneof tools wehaveathandandalltheyettobeinvited must beboldand unapologetic, and we mustuseallthe and police,oureffortstovanquish harm fromourlives narratives. Liketheroadtowardsablitionofprisons signifying dangerandcomplicatingharmfulpublic meta sites/traditions andontolesscomplexactslikepublicly nities isharmreduction, expandingfrom safeinjection all andanyofthewayswemediateharmtoourcommu reduce harmtoourselvesand our communities. Forme, there isaworld-making possibilityinoureffortsto these explorationspublic now,in2021,showsmehow (to some)realitiesand survival mechanisms.Making strived tomakespaceformyownpersonal,unseen works since2014(and previously forthatmatter)have Hindsight being2020Inowrealizethatmanyofmy Abolition asHarmReduction charles ryanlong @discojihad
- - REPRINT 69 CHARLES RYAN LONG you joinme? proclamations theymakeasnolongernecessary...won’t time and begin tolookbackand view themessagesand ble again.Itismyhopetoreturnartworksover harm, wemakewhatwant,need,anddeservepossi alternatives tothesystemsthatcauseusgreatest our effortsofmutualaid andthecontinued buildingof firmer inourconvictionsthatwegotusandthrough iron onpatch(designedfor VisualAIDS’PlaySmart) Dirty &Proud,2014 - REPRINT 70 CHARLES RYAN LONG charles ryan long andChristopherPaul Jordan, charles ryanlong, I amHIVx CLEAN , 2014 , 2018 ↝ REPRINT 71 CHARLES RYAN LONG charles ryanlong,forVisualAIDS,2019 charles ryanlong, WDWD, 2020 REPRINT 72 PROJECT SAFE organization of:women,non-binary,gendernon-conform Project SAFEisagrassrootsdirect-serviceandpeer-based isolation. “Yourability tomaintaineconomicstability the drugmarket,economic contraction,andself- that overdoserates willrisebecauseoffluctuationsin “[Project SAFE]Board member JeanetteBowlesworries in theageofCOVID-19: economiesinKensington.Readmoreabouttheirwork street centered harmreductionservicestopeople involvedinthe ing, andtranspeople,providingwomen femme- Need HelpWith... Project SAFE @safephila Project SAFE,graphic,2020
- ↝ REPRINT 73 PROJECT SAFE normally wouldn’t, becauseofscarcity.” ing forpeoplewhoarehavingtoworkinsituationsthey more requestsforpepperspray,and we’ve beenprepar but notmakingenoughmoneyfordrugs.We’vegotten nator forProjectSAFE.“Peoplearehustlingevenharder, slow,” saidLuluDuffy-Tumasz,deliveryservicescoordi affected bytherecentcontraction.“Businessisreally sex workers—andworkisanothereconomicarea What’s more,manyofProjectSAFE’sparticipantsare you’re homeless. access toaphone.It’shard to hangonto onewhen many ofProjectSAFE’sparticipantsdon’thavestable disclosing theirdruguseand address toastranger,and you becomeunresponsive.Butpeoplearewaryabout tor whowillstayonthelinewhileyouuse,calling911if The national“NeverUseAlone”hotlineoffersanopera we’re tellingthemtostayhome.” one ofthebiggestriskfactorsforoverdose—butnow people foryearsthattheyshould never usealone—that’s affects overdoserisk,”shesaid.“And we’vebeentelling long intotheCovid-19crisis”,bySophiePinkhan,for deaths climbadvocatesandactivistsfeartheopioid crisiswillrunhead Full article:“TheChallengeofTreating2Epidemics atOnce:Asoverdose TheNation. - - - - REPRINT 74 JADE FORREST MARKS soprano onvariousprojects,like thestickers below. they workwithfellowharmreductionistandartistripley accessibility, andharmreduction.Aspartoftheirofferings, herbalism, byblendingfocusontransandqueerhealth, of collectivehealingbyblendingfantasy,faggotry,andfolk project byjadeforrestmarks,thataestheticizesadream 69herbs isaNewYork-basedapothecaryanddesign See moreat69herbs.com. as community,healing,andawayoflifeemerges. together harmreductionaspunk,queer,loving, Each workisapowerfulstatementonitsown,whenseen Jade ForrestMarksandripleysoprano Harm ReductionStickers @69herbs @suck_dick_carry_narcan Jade ForrestMarks,sticker, 2020 Jade ForrestMarks,sticker,2020
↝ REPRINT 75 JADE FORREST MARKS Jade Forrest Marks andripleysoprano, sticker,2019 Jade ForrestMarks,sticker,2020 Jade ForrestMarks,sticker,2020 REPRINT 76 RIPLEY SOPRANO & JADE FORREST MARKS and medical systems. been historicallyexcluded frominstitutionalresources people wholiveonthe streets,andotherswhohave users, HIV+people, sick, crazy,and disabled people, Harm reduxishistoricallyledbyhookers, faggots,drug grassroots communityorganizing+street based care. HARM REDUCTIONISaframeworkrooted inthelegacyof VOTING ISHARMREDUCTION ripley soprano+JadeForrestMarks another faggotmoves EVERY TIMEYOUSAY to hell’skitchen...* David Wojnarowicz’sjacketatACTUP’sFDAAction, October 11,1988.PhotobyBillDobbs
* A joke about assimilation, homonormativity, and real estate real and homonormativity, assimilation, about joke A REPRINT 77 RIPLEY SOPRANO & JADE FORREST MARKS choose to optoutofvoting. reasons whymarginalized peoplecan’tvote,orwould We knowfromourhistory thattherearecountless collectively inheritedand did not choose into. politics oftheState;intwopartysystem thatwehave Voting is(juststatingfacts)aparticipation intheelectoral and by. always killedand neglected thosewhoharmredux isfor whorephobic, homophobic,transphobic statethathas built ongenocideandslavery;aninherentlyanti-Black, (As weknow...)theUnitedStatesisacolonialempire VOTING ISNOTHARMREDUCTION is rootedinaspecifichistoryand vision. less thananewworld order. Theterm “harmreduction” healthcare forall,people’srunhealthservices,nothing The demandsofharmreduction arefree housingand The demandsofharmreduction arenot reformist. to resources. simple: noonedeservestodiefromlackofaccess shame and stigma. It’smainprincipleisasradicalit Harm reduxisthepeople’smedicine,itanantidoteto free condoms. birth controlaccess,suboxoneandmethadone, strips, Narcan,saferinjectionsites,PrEP,abortionand Harm reduxiscleanneedlesand pipes, fentanyltest
REPRINT 78 RIPLEY SOPRANO & JADE FORREST MARKS with callingitharmreduction voter access,cool-but let’scallitforwhat itis.+let’schill was builtthisway.Ifyou’reintovotingandincreasing US colonizedterritories(ieallofPuertoRico).Thesystem felony records,undocumentedpeople,and residents of LEGALLY excludesincarcerated people, peoplewith non-voters. Plsrememberthatvotingcurrently+ especially ofBlack&latinxindigenouscriminal Pls plsstep back withthenon-voter shaming~ this framework. white washing,andliberalizingtheradicallegacyof harm reductionwiththislanguageareassimilating, use matters.Attemptstobringvotingintotheframeof harm reductionisamisappropriation.Thelanguagewe ticket is,infact,“reducingharm,”usingthelanguageof Whether ornotonebelieve’sthatvotingforaDemocratic refuse tostigmatizeand shame peoplefornotvoting. An actualharmreductionapproachtovotingistruly upholds acommitmenttoendingshameandstigma. The brillianceandbeautyofharmreduction isthatit
↝ REPRINT 79 RIPLEY SOPRANO & JADE FORREST MARKS Instructions forsterilizingusedsyringeswithbleach, 1992 Clean NeedlesNow,VehicleinMacArthurParkarea,1995 Keith Mayerson&ACTUP,
REPRINT 80 INDIGENOUS ACTION Action wasfoundedonAugust25th,2001toprovidestra liberation forMotherEarthandallherbeings.Indigenous agitators thatworktogetheronaproject-by-projectbasisfor Indigenous mediamakers,designers,artists,writers,and radical volunteercrewofanti-colonialandanti-capitalist Indigenous Action(originallyMedia)isa
Click Perspective. Hereisthecoverandopeningparagraph. released VotingisNotHarmReduction—An Indigenous of theupcomingUSgeneralelection,IndigenousAction and distributionofzines.InFebruary2020,inanticipation their practiceisthecreationofmedia,includingmaking workshops, conferences,benefits,andmuchmore.Vitalto have organized hundreds of actions, marches, banner drops, nous community’ssacredlandsdefense.Overtheyearsthey tegic communicationsanddirectactionsupportforIndige dollars competing forvotes? budgets ofpoliticians whospend hundreds ofmillions compare sexualviolence statistics?Isitinthemassive desecrations? Dowe balanceincarcerationrates?Dowe Do wefactorinpipelines,mines,dams, sacredsite drone strikes?Orwhohad the highestmilitarybudget? Do weadd up what politicalpartyconducted more undocumented IndigenousPeopleshave beendeported? calculated. Dowecomparehowmanymillions of reduction,” it’sneverclearhowlessharm isactually When proclamationsaremadethat“votingisharm here toseethefullzine. Voting isNotHarmReduction Indigenous Action @media_action
- - ↝ REPRINT 81 INDIGENOUS ACTION Indigenous Action,2020 ESSAY 82 ALEXANDER McCLELLAND Where Will HIV Be in10years? Alexander McClelland @alexmcclelland
ESSAY 83 ALEXANDER McCLELLAND goods, ownedbythepeople.Development medical technologies,andexpertise,willbecommon All biomedicalknowledge,past,current,andcutting-edge way welive. dismantled. Collectivityandcollaborationwillbethe Individual formsofleadershipand competition willbe understood asvitaltocommunityhealthandwell-being. as wellpreservationofthelandandresources,willbe Connection totheland,eachother,and to resources, Interdependence willbeprivileged over marketability. be governed through traditionalways ofknowing. land toIndigenouscommunities.TurtleIslandwill By 2031,settlerswillhaveconceded all controlofthe beyond wherewearenow. My thoughtsareanefforttoopenimaginationsandsee policy, oppressivelaws,andharmfulresearchpractices. I’m tired of beinginareactiveposition–reactingtobad describe isanimaginaryvisionfor10yearsfromnow. a recentHIVresearchconferenceinCanada.WhatI I wasaskedtosharemyutopianvisionfor2031at and epidemiological research—willbeinverted. Top-down systemsof surveillance—suchaspublichealth and compounds,willbeabolished. proprietorship overmedicines,chemicals, of society.Thepatentsystemwillbeundone, andsole individual capitalgains,but throughthebetterment of thecommons,andwillberewarded, notthrough of newknowledgeonhealthand well-being willbepart
ESSAY 84 ALEXANDER McCLELLAND researchers primarily beingfromthosecommunities. directions forhowthedatatrustscanbe mobilized,with it all.Differentcommunitieswillsettheir ownresearch Those whoaremostimpacted will beatthecenterof drugs, Blackpeople,Indigenous andsoon. people livingwithHIV.Onewillexistfor peoplewhouse data aboutyourlifebepartofatrustrunbyand for key. IfyouarelivingwithHIV,couldopt-intohave consent, andwhereautonomydataprotectionare systems, withdynamic,transparent,and ongoing Data fromcommunitieswillbecollectedthroughopt-in collective dataofothers). (so variousdifferentpopulationscouldbenefitfromthe help improvehowyoualllive),aswellpopulations about peopleinyourneighbourhood can beusedto of datatrustswillexist,based on geography (sodata community leadersand experts. Many differenttypes private industry—but byagovernancecollectiveof is managed and overseen—not bygovernmentsor A datatrustisastewardship platform, wheredata community needstosupport healthandwell-being. communities. Datawillbemobilized in theserviceof trusts, whichwillbeowned and governed by local Data aboutourliveswillbeheldincommunitydata few, andthenusedtostudyusasobjects. Data aboutourliveswillnotbeextracted,held only bya will needto demonstratetheir ethicalresponsibilities to access tothedatafrom atrusttoconductresearch,they If someoneoutside a communitywantstoapply tohave
ESSAY 85 ALEXANDER McCLELLAND as “hard-to-reach”peopleor“at-risk”communities, information aboutourlives.Therewillbe nosuchthing as activesubjectswithautonomyandcontrol over People willnotbeviewed as objectsofstudy,butrather what isbestfortheirownlives. we willlivewithanewtrustofothers,toknow dialogue, willalsobegonefromyourmind in 2031… you—or othersortsofexperts—knowbetter,thatinner be trustedtoknowand define whatthey need,and that vation won’thappenthisway,thatcommunitiescan’t saying isunrealistic,notpossible,far-fetched,thatinno The innerdialogueyouhavetellingthatwhatI’m benefit, asdeterminedbycommunitiesthemselves. Algorithms willberegulated and used only forcollective information onpeople’slives,patterns,andbehaviours. forms ofcapitaloffcollectingpeople’sbiomaterial,and lives fromoutside.Itwillnolongerbepossibletobuild label, ordiagnose,and to theninterveneinpeople’s and tobeusedexternallypathologize,classify, It willnolongerbepossiblefordatatoweaponized, and willbenefitthecommunity. research, arealignedwithcommunityresearchpriorities that community,and must outlinehowoutcomesoftheir abundance ofresources tosupportthemselves. undone. Instead,communities willbeprovidedwithan health, socialworkers,andexternalresearchers willbe as aninterventionistandsurveillancelogic ofpublic
- ESSAY 86 ALEXANDER McCLELLAND who depend on drugsregularlyforsurvival, willnot problem, willbenomore.Thesmallnumberofpeople which viewsanyformofdependenceasafailingor issue, orarisk,problem.Neoliberalindividualism, liberation. Drugusewillbeunderstood not asamedical ization. Wewillhaverealized total and complete drug We willseebeyond drug decriminalization and legal accountability. ties willemployrestorativejusticemodelsofcommunity anyone enactsharmtoanotherperson,localcommuni deep respect fortheother.Inrareinstancewhere by acollectiveunderstandingof“donoharm”with infrastructure willbedismantled.Welivegoverned criminal justicesystem,laws,prisons,and policing legal systemwillbeabolished,meaningtheoppressive social stigmaand discrimination. Thesettlercolonial structural oppression,harmfullaws,and the resulting constant reactivepositionoffightingagainstforms to Indigenouscommunities,wewillnolongerbeina As aresultofsettlersconcedingcontroltheland be available towhomeverneeds them.Wewillsupport mization. Drugsupplies willberegulated,anddrugs reduction, itwillbe reconceptualized as pleasuremaxi through thelensof pleasure. Wewon’tneedharm Outside ofpainrelief,drugusewillnow onlybeviewed and toresources. interdependence allofushavetoeach other, toland, each other,willbeunderstoodaspartof thenatural as humandependenceonsubstances,things, andon be seenashavingadisorder,oranindividualfailing,
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- - ↝ ESSAY 87 ALEXANDER McCLELLAND BIO past, wewillallliveinabundance.Weflourish. food sources. Scarcityand austerity willbeathingofthe access tohousing,cleandrinkingwater,sustainable to supporttheirownneeds.Allcommunitieswillhave will beequitablyredistributed to enable communities we willallhavearealisticguaranteed income. Resources Poverty willbeeradicated,billionairesabolished, be nomore. talk oferadicatingorendingHIV,and the logicofriskwill pathologized, and stigmatized. There will benoneedto not anindividual moralfailing,thatissensationalized, HIV willbeunderstoodasacommonhumanexperience, security and well-being. inal recordspreventingpeoplefromrealizingeconomic will bereleased,andtherenosuchthingascrim sex work,HIVcriminalization,andotherso-calledcrimes, People whohadbeenincarceratedfordrugpenalties, autonomy, andtofeelasmuchpleasurepossible. each othertofeelthebesttheycan,havecognitive and Criminal Justice,inOttawa,Canada. an Assistant Professor atCarletonUniversity’s InstituteofCriminology Alexander McClellandhas beenlivingwithHIVforover20years.Heis Not Clusters!,”TheAmericanJournalof Bioethics,20:10(2020) Mx BrianMinalga,Andrew Spieldenner&SeanStrub,“ Marco Castro-Bojorquez,MartinFrench,DevinHursey, NainaKhanna, Edwin J.Bernard,AlexanderMcClelland,BarbCardell, CeciliaChung, Data 4BackLives Response toHepatitisC&HIV Alexander McClelland&ZoëDodd,” SOURCES ANDRESOURCES ,” (2015) Thoughts onanAnarchist We ArePeople, - REPRINT 88 SALONEE BHAMAN get toplaythestarring roleinhistory?Whocounts? decides whatdocumentsaresaved?Which characters them? Thiscanbethetrapofarchive aswell:who to learnfromthesedocuments?Whydid someonesave sense ofurgencyforahistorian:whatare wesupposed carefully preserved artifacts ofthepastcancreatea objects, andtotellthesestories.Rifling throughthese know about.Someonemadeachoicetopreservethese that someone,somewhere,feltthefuturemust Inside eachdustyboxorslideofmicrofilmisasnippet waiting tobeputtogetherandmaderecognizable. secrets, and clues aboutthepastthat allseemtobe an archivalrepository:theyhold within themstories, There’s somethingpowerfulaboutthepromiseof Talking Back. American FeministCollectivezine,Solidarity,Politicizing, Bhaman statesinhertext“TheArchive”fortheAsian we rememberthat“wemakehistories,”ashistorianSalonee When wegiveuptheideathatonlyinstitutionsholdpast, dive bar,yourphone—whereverstoriescanbeshared. the archiveisyouraunt’scloset,laststallinlocal Too often,archives are resigned to thehallowed A harmreductionapproachtohistoryunderstandsthat Harm ReductionandTheArchive Asian American Feminist Collective Salonee Bhamanforthe @aafcollective @saloneee
↝ REPRINT 89 SALONEE BHAMAN of feministhistoricalpractice. familial objects,andcommunitylearningareatthecore treated with thereverenceofHistory. Oralhistories, and committedtopapertapestorieswaitingbe we loveorrespectknow,waitingtobecoaxed out away inaphotoalbum,orthemindsofsomeone found. Often,thesestoriesareinourhomes,tucked that lacktangibleform.Luckily,thesestoriescanbe and thestoriesofdiaspora,migration, displacement and caregiverswhonurturedmovements people, find theworkingpeoplewhomakeacityrun,women ing withingapsand silences and implications, inorderto can accessthemmustreadbetweenthelines,interpret repositories ofuniversitiesandmunicipalities.Thosewho Read thefullzinehere. W e make histories. We make - ↝ CREDITS 90 WWHIVDD? Poster Design Zine Design Copy Editors Editors Lenape land,withcontributionsfrompeopleacrossTurtleIsland. This documentwascollectedandeditedbypeoplelivingon visualaids.org |@visual_aids HIV positiveartists,andpreservingalegacy,becauseAIDSisnotover. Visual AIDSutilizesarttofightbyprovokingdialogue,supporting hivdoula.work response totheongoingAIDSCrisis. What WouldanHIVDoulaDo?isacommunityofpeoplejoinedin Jade ForrestMarks Aaron Fowler Blake Paskal,Cea(ConstantineJones) Alexandra Juhasz,MollyPearson,JohnFreeman,KyleCroft, David OscarHarvey,TamaraOyolaSantigo,andJenniferBrier) for WWHIVDD(Abdul-AliyAMuhammad,MollyPearson, for VisualAIDS,andtheHarmReductionZineworkingcommittee Theodore (ted)KerrforWWHIVDD;KyleCroftandBlakePaskal spring. Yourworkwasdeeplyinfluentialtothemakingofthiszine. (AQPSUD) forthegenerousinvitationtoconsiderharmreductionthis pour lapromotiondesantédespersonnesutilisatricesdrogues WWHIVDD wouldliketothankBennifromL’AssociationQuébécoise Doula Do?andVisualAIDSattheinvitationofPS1. Harm ReductionisNotaMetaphorwascreatedbyWhatWouldanHIV |@wwhivdd CREDITS
HARM REDUCTION IS NOT A METAPHOR