Safe spaces2012

The need for Safe Spaces in HIV Prevention Among

Marginalized, Criminalized, and Oppressed Communities

Lindsay Roth & Kahn Miller of

Is it ?

Who We Are, What We Do

• All volunteer, grassroots harm reduction group for working women in north Philly

Kensington:• One of the poorest neighborhoods in Philadelphia with

prominent open air markets for heroin, powder and rock cocaine, street-based sex trade

• HIV/AIDS rate for zip codes 19125 and 19134 some of the highest in the city. City wide Philadelphia has HIV/AIDS rate three times higher than the national average.

• Late Night Street Outreach• Bad Date Alerts

• Home Deliveries• Case Management

• Health & Safety Tips• Overdose Response Training

• Rape and Assault Referrals• Women Identified-Only Drop-In

• Bilingual Services

This Includes…

What is Harm Reduction?

What is Harm Reduction?

• A public health theory addressing behaviors that carry risk.

• We all do things we know are bad for us, and only the individual can decide what measures to take to mitigate harm

• Those who engage in these behaviors should have a leading voice in any organization or program they utilize

THIS IS A SAFE SPACE

A big thanks to SWOP- NYC/SWANK for sharing their guidelines with us!

• Confidentiality: What’s shared here stays here, what’s learned here leaves here.

• One Mic • Make Room, Make Noise • Ouch/Oops• If you don’t know - ask!• Speak from the “I”• Please do not record this

presentation. (The slide show with bibliography and notes will be made available)

Some guidelines

Workshop Objectives

• Define Safe Space: history and origins, harm reduction philosophy.

• Why they are an effective and necessary tool in HIV prevention

• How to create and maintain a safe space .

wwav-no.org

Intended Audience

Providers: D/A counselors, Case Mangers, Doctors, RNs, CRNs, Social

Workers, Therapists,

Parole Officers, Case Workers,

DHS Worker, Teachers, HIV

Testers & Counselors

People: Just because you do not have letters after your name, this is for you too! Lived experience cannot be overvalued.

What else makes a space “safe”?

• Area or forum where a marginalized group is free of standard stereotypes, discrimination, and tactics of silencing

• Physically safe: free of law enforcement/other institutions, potential clients and assault

• There are guidelines: “trolling” should not be tolerated

• Meeting people where they are at• Non-judgmental

• Community involvement and leadership• Addresses material needs and structural

oppressions simultaneously

Why safe spaces are an effective and necessary tool for HIV

preventionGood for

Organizations• Community

involvement builds trust

• Builds knowledge of lived experience and on-the-ground realities where research falls short -especially situations that are a product of structural issues

• Narrows the gap between provider and participant

Good for At-Risk Communities

• Skill share/peer education

• Empowerment and self-actualization, especially for extremely marginalized/criminalized populations and those with intersecting oppressions

• Decreases isolation from prevention resources

Why safe spaces are an effective and necessary tool for HIV

prevention

Why safe spaces are an effective and necessary tool for HIV

preventionGood for

Organizations• Community

involvement builds trust

• Builds knowledge of lived experience and on-the-ground realities where research falls short -especially situations that are a product of structural issues

• Narrows the gap between provider and participant

Good for At-Risk Communities

• Skill share/peer education

• Empowerment and self-actualization, especially for extremely marginalized/criminalized populations and those with intersecting oppressions

• Decreases isolation from prevention resources

the Sonagachi Project in Kolkata, India

3 Rs: respect for sex work and those involved in it; reliance on sex workers to run the program; recognition of sex workers’ rights. Condom use rose from 27% in 1992 to 86% in 2001; HIV prevalence in sex workers dropped.

Scarlet Alliance in Australia Autonomous sex worker organization formed in response to HIV/AIDS crisis. Peer education led to increased condom use.

Today sex workers are consulted in the formation of policy on state and national levels. In a country where many forms of sex work are legalized, transmission of HIV via unprotected transactional sex accounted for less than 1% of new cases in 2009.

SHAKTI in Bangladesh

Through peereducation and

outreach,knowledge of the

benefits of condom use increased

from 37% to 86% (1994-97; survey

conducted by peer educators) and

condom use with clients increased

20% to 70% (1996-99).

Peer education and outreach has resulted in increase of condom use and STI

testing/interactions with public health institutions. Peer education is now the gold standard for HIV prevention in Kenya where it is estimated

7, 000 people engage in sex work.

SWOP in Nairobi, Kenya

John Mathenke, a Nairobi sex worker, was diagnosed with HIV in early July. He is working with the Sex Workers' Outreach Program to educate other sex workers about HIV prevention. Photo by Siena Anstis.

Safe Spaces as Prevention• People are not comfortable being

honest about behaviors if they are not free of stigma, judgment, and possibility of punishment or prosecution

• Ownership and shared perspectives that can only be accumulated from lived experience lead to more accurate info

• Fosters peer education, proven to increase condom use and lower rates of HIV among sex workers in programs around the world

FAIL

How to Create and Sustain Safe Spaces

• As provider, your job is to get the ball rolling:• Tap into existing community structures and

leaders - reach out!• Self-determination of programming - or lack

thereof - much of which will happen organically

Logistics• Low-threshold• Location and

time, including original use for the space

• Provide incentives such as tokens, food, supplies

• Consistency

• Sometimes personal relationships can trump logistical barriers

• If mandatory program (incarceration, court ordered drug treatment), theories and practices of safe spaces can be included

• Think outside the box

what not to do• Don’t offer advice

unless asked but DO recognize behavior change that comes from within

• Don’t assume a singular identity; don’t generalize

• Don’t try to do it all at once; the small things count

• Don’t exploit the space or the participants

Intentionality and Framing • Without intentionally, there is almost

always a reproduction of structural oppressions within the organization or program

• Strategic Essentialism – for the most marginalized of populations it is sometimes necessary to reach out to a specific group so that they may self-actualize

The Empty Room….The Empty Room….

• If you don’t know, ask: link up with someone in the community and listen to them

• And keep asking; this is a continuous process

Participants as Consultants

• They know more than you do; avoid privileging institutional learning, degrees, and resumes

• A truly safe space necessitates direct community involvement and leadership

• As with any other consultant they should be compensated fairly and financially, their expertise respected as such

Consultation & Self-Advocacy• VANDU, Nothing About Us Without Us• Young Women’s Empowerment Project (Chicago),

Girls Do What They Have To Do To Survive: Illuminating Methods used by Girls in the Sex Trade and Street Economy to Fight Back and Heal

• Youth United for Change (Phila), Pushed Out: Youth Voices on the Drop-Out Crisis in Philadelphia

And a note to participants…• How to get your needs met and built a

successful community:– Never assume someone knows how you feel – Follow the rules set forth at your organization – Work within the system to self advocate when

you feel someone is breaking the rules or breaking your trust. Don’t lose your temper: talk to them directly or talk to their supervisor

• You are the expert: You have an important set of skills to share with people.

What if everyone had a safe space to speak?

Imagine if you had a safe space at your organization or in your work-place where you could really listen to your clients or

patients?

Think how you could implement some aspects of a safe space –

or even how you are already doing so.

Think about how you can collaborate to create one for yourself.

Thank You!