User:Manorhe18/Harm reduction
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Sex work and HIV [[editing section- joining "Decriminalisation" and this section together]]
Despite the depth of knowledge of HIV/AIDS, rapid transmission has occurred globally in sex workers.[1] The relationship between these two variables greatly increases the risk of transmission among these populations, and also to anyone associated with them, such as their sexual partners, their children, and eventually the population at large.[1]
Many street-level harm-reduction strategies have succeeded in reducing HIV transmission in injecting drug users and sex-workers.[2] HIV education, HIV testing, condom use, and safer-sex negotiation greatly decreases the risk to the disease.[2][3] Peer education as a harm reduction strategy has especially reduced the risk of HIV infection, such as in Chad, where this method was the most cost-effective per infection prevented.[2]
Decriminalisation
The threat of criminal repercussions marginalizes sex-workers and people who inject substances, often resulting in high-risk behaviour, increasing the rate of overdose, infectious disease transmission, and violence.[4][failed verification] Decriminalisation as a harm-reduction strategy gives the ability to treat substance use disorder solely as a public health issue rather than a criminal activity. This enables other harm-reduction strategies to be employed, which results in a lower incidence of HIV infection.[5]
The HIV/AIDS epidemic One of the first harm reduction models was called the “Mersey Harm Reduction Model '' in 1980s Liverpool, and the success of utilizing outreach workers, distribution of education, and providing clean equipment to drug users was shown in the fact that an HIV epidemic did not happen in Mersey. This catapulted the model into International conferences on drug related harm in the midst of the AIDS epidemic, making it an internationally recognized model of preventing HIV/AIDS specifically within injecting drug user populations. There was much connection between San Francisco (an epicenter of HIV/AIDS advocacy in the US) and Liverpool. Harm reduction slowly began to transform the action around drug use from an individualistic approach that mainstream US healthcare often relies on, towards a more holistic population-based approach.
The AIDS epidemic, which began in the 80s and peaked in 1995, further complicated the politicization of drug users and drug use in the US. The implementation of harm reduction faced much resistance within the US due to the demonization of particular drugs associated with stigmatized groups, such as sex workers and drug-injecting users8.
New Section: Harm Reduction in Mainstream US Healthcare
The debate and perceptions around drug use within the US is impacted by healthcare wider socio-political movements: namely, the War on Drugs and the HIV/AIDS epidemic/activism. Addiction has long been considered within healthcare policy and funding as an individual's poor behavioral choice or an “irresponsible hedonistic lifestyle”. Within healthcare, drug abuse and rehabilitation was segregated from mainstream healthcare and is often relegated to privatized institutions- substance abuse treatment was not covered by insurance until the Affordable Care Act in 2010. Patients are stigmatized, segregated, and marginalized both within politics and public perceptions, but also often within the institutions that they seek care in 12.
Within the Obama Administration, although the rhetoric and criminal frameworks of the War on Drugs was lessened, there was still twice as much money going into criminalizing drugs in the justice system than was going to drug treatment and prevention 11. The effects of the War on Drugs is that it prevented individuals from seeking addiction treatment and utilizing harm reduction, according to the Drug Policy Alliance. Within education throughout the War on Drugs, there is also an overwhelmingly abstinence-only approach to drugs which further contributes to proliferating the problem of substance abuse 10.
References
- ^ a b Hilton BA; Thompson R; Moore-Dempsey L; Janzen RG (February 2001). "Harm reduction theories and strategies for control of human immunodeficiency virus: a review of the literature". J Adv Nurs. 33 (3): 357–70. doi:10.1046/j.1365-2648.2001.01672.x. PMID 11251723.
- ^ a b c Rekart ML (December 2005). "Sex-work harm reduction". Lancet. 366 (9503): 2123–34. doi:10.1016/S0140-6736(05)67732-X. PMID 16360791.
- ^ (Organization), Human Rights Watch (2004). Thailand, not enough graves : the war on drugs, HIV/AIDS, and violations of human rights. Human Rights Watch. OCLC 56024188.
- ^ Hathaway AD; Tousaw KI (February 2008). "Harm reduction headway and continuing resistance: insights from safe injection in the city of Vancouver". Int. J. Drug Policy. 19 (1): 11–16. doi:10.1016/j.drugpo.2007.11.006. PMID 18164610.
- ^ Rekart ML (December 2005). "Sex-work harm reduction". Lancet. 366 (9503): 2123–34. doi:10.1016/S0140-6736(05)67732-X. PMID 16360791.