Harm Reduction in the USA: A Movement Toward Social Justice
(with Sara Kershnar)
Roxbury is the poorest neighborhood in Boston. Over half of its population, primarily African-American and Latino, live below the poverty line. People living in Roxbury suffer more ill-health and are more likely to die from heart disease and cancer than people who live in other, wealthier parts of Boston. They are also more likely to die of AIDS – twice as likely. If you look at women and men separately, the women of Roxbury are over three times as likely to die of AIDS than women living elsewhere in Boston (Boston Public Health Commission 1998).
This local situation is repeated in poor, urban communities across the nation. The highest rate of new cases of HIV infection in the USA is now among young women of color. Official reports will tell you that the greatest risk factor for these young women is sex with a male injection drug user. But this is to miss the larger picture. Drug policy, in the form of the War on Drugs, has denied people access to life-saving clean injection equipment. Incarcerating nearly a whole generation of young men of color from the inner city, the bulk for non-violent drug offenses, has damaged their life prospects for good. Not only can prison increase their chances of getting HIV, through sharing dirty needles and having unprotected sex (both common realities inside), but it also reduces their options for making a better life for themselves on the ‘outside’.