Friday, September 28, 2007


There are no telling how many ways in my fearful imagination that the Greta Perry's of the world--although I don't think there are any others--would possibly revel in the repercussions of my various stupidities. (Just as soon as I am smart enough to figure out how to, I will text-section-link my reference here to the enjoyment she expresses in "Kiss My Gumbo" of the legal consequences for the lapses of judgment of two women who to tried to sell their illegal favors on Craigslist.)

But I can think of only one service that I would be brazen enough to advertise publicly online legalized or not--(and I did it in the sidebar of my blog +Positive House)--which is the back alley HIV prevention service of needle exchange. Needle exchange is the on-site service of anonymous exchange of used hypodermic syringes for sterile ones, which promotes or condones (in the eyes of opponents) illegal drug and un-medically-supervised hormone use by addicts and transgenders (who they don't even usually call that). (Needle exchange is currently specifically disparaged in a San Francisco Chronicle series by C.W. Nevius on Mayor Gavin Newsom's current campaign to clean parts of San Francisco of homelessness and its effects.)

In proponents' eyes--nurses, many service providers, and diverse kinds of volunteers that I know of, and researchers that I hear of and will re-learn to site if comments (I hope) warrant--counter that the service of one-to-one needle exchange, besides directly intervening in transmission of HIV and other infections between needle-users, creates an in the field (alley) venue for both direct medical interventions (such as wound care for abscesses caused by repeated use of unsterilized syringes) and also for referral into healthcare, testing, counseling, and addictions treatment services. Bringing controversially compassionate care into alleys sometimes builds bridges of trust with people who would not otherwise seek help or neccessarily trust potential solutions to their problems, resulting in life-sustaining benefits for them and for a lot of the rest of us. Dirty needles get picked up off the streets and turned in as the biohazard that they are, preventing more contaminated intentional use and possible unintended needle sticks by non-users as well.

My free public advertisement of the HIV prevention service of needle exchange is due in no small or impersonal part to the facts that women (and other people) do get infected with HIV (and other things) by boyfriends (and husbands and others) who use without their disillusioned female (and other) partners ever knowing that they (the boyfriends and others) ever used drugs (or recovered)--when they (the women and other partners) never used those kinds of drugs for real and wouldn't even know how to talk about cooking up and hitting a vein themselves. Call me stupid. I got it. And my boyfriend died.

That was a long time ago, before needle exchange was legalized, before it had mobilized at all. I don't know if my boyfriend would have taken advantage of it. There is no time for that conversation.

For this issue, life first. Illegality, carelessness, addiction, life-risking misrepresentation, anger, confusion, grief, fear, shame, resentment, regret, judgement, some order, after.


Anonymous said...

There was an article in today's San Francisco Chronicle about a neighborhood banding together to keep a needle exchange from locating in a nearby church. They are trying to put their lives first. It's too bad they can't put life first at the same time they are putting their lives first. But maybe to do both would require a wake up call.....

+House caretaker said...

Thank you for your comment. I looked up the article in SFGate. Because needle exchange matters so much and is so controversial and "dirty," it matters that it is run and managed well, and that sites are located where the problems already exist. I'm sure there are people in "those" problem neighborhoods that don't want homeless people, addicts, and dirty needles around either, but they might be a little more aware of the problems and their repurcussions and welcoming of the help needle exchange can bring. The program that I am familiar with and respect is HPP (HIV Prevention Project run by the SanFrancisco AIDS Foundation). Bringing a needle exchange site to a church is not an effective way to raise awareness where it doesn't exist. That said I was hurt by the spirit of the article and its responses.

M. said...

Good work, explaining the importance of volunteers in that complicated ministry. M.

+PHc said...

Thank you, M.