Latin@ Lives and the Next Generation of Latin@ Lives and the Next Generation of HIV Prevention: Policies, Politics and HIV Prevention: Policies, Politics and ResearchResearch

Joyce A. Rivera, St. Ann’s Corner of Harm Reduction,

Sponsored by CHAMP

July 9, 2008

Harm reduction practice mediates substance Harm reduction practice mediates substance use by providing self-management strategies use by providing self-management strategies that are immediately effective in reducing that are immediately effective in reducing personal and communal harm.personal and communal harm.

© © J. Rivera & B. Majoor, 2003J. Rivera & B. Majoor, 2003

•Belief in the dignity and worth of every human life;Belief in the dignity and worth of every human life;

•All physical, social and economic distinctions represent All physical, social and economic distinctions represent opportunities for experiencing wholeness through the practice of opportunities for experiencing wholeness through the practice of tolerance, compassion, empathy, and goodwill;tolerance, compassion, empathy, and goodwill;

•Our beliefs inform our mission, constructed in late 20Our beliefs inform our mission, constructed in late 20thth century century New York (1990), summarized as, “the point is to save lives”.New York (1990), summarized as, “the point is to save lives”.

SACHR

A useful tool to view Complexity – both qualitatively and quantitatively – from reference states that change over time:

Can identify connections outside of the realm of accepted orthodoxy;

Can temporally mediate connections; Can structure an intervention.

Substance Usecan increase HIV-risk behaviors

and increases risk of mentaldisorders

Mental Disordersmay increase impulsivity

and impair problem solving,increasing risk for substanceuse and HIV-risky behaviors

HIV/AIDScan increase risk of mental

Illness (depression, anxiety, sleep disorders)

and substance use disorders

© Majoor, 2004

COMPLEXITYCOMPLEXITY

Alcohol Crack Cocaine Hashish Marihuana Poppers Ecstacy Ketamine Methamphetamine Heroin Legal Drugs

ACKNOWLEDGE THE ROLE OF SUBSTANCES IN MSM, IDU AND HETEROSEXUAL TRANSMISSION OF HIV/AIDS/HEPc

Source: Community Health Profile Hunts Point/Mott Haven, NYC DOH&MH, 2003

15.3% of the US pop, including its colonies; 24.8% of HIV diagnoses, since the beginning

of the epidemic; Names-based reporting & failure to include

Puerto Ricans in the counting of US Latinos means that an estimated 40% of the Latino population remains uncounted in the national HIVF reporting or even HIV reporting.

Hispanics Non-Hisp, Whites HIV/AIDS, Rep. 22.5 8.2 AIDS Dx 15.4 5.4 AIDS Dx, 12 mo. 14.0* 5.1 HIV/AIDs mortality 5.5 1.9 Living w/HIV/AIDS 191.5 68.1 AIDS cases, 1981 -- 418.8 194.3 HIV Dx, 1981 -- 103.6 49.2 AIDS mortality, ‘81 182.2 120.5

* According to CDC, Puerto Rico, Virgin Islands, and D.C., report > 42% of Latinos were diagnosed with full-blown AIDS w/in a year of testing positive—meaning they didn’t become aware of or connected to care for their infection i=until extremely late in the course of their illness.

Diminished personal and familial sovereignty;

Conditioned to accept the State as an authority in their lives;

Conditioned to accept the Medical Model as unquestioned authority in their lives.

MILLENIAL PATRIARCHY

Predominant participant group in syringe exchange in NY & across the US;

Demonstrated Syringe Exchange to be the (most researched) only DEBI with proven short & long term effectiveness;

Our community has shown courage and commitment to its whole SELF; Synergistic: Behavior of the whole system not implicit in any of the behavioral characteristics of any of the parts of the system when these parts are considered only separately.

As of June 1997, two-thirds of the AIDS cases in Hispanic women were directly linked to injecting drug use: 42.8% of Hispanic women contracted AIDS by injecting drugs, and an additional 23.2% contracted the disease through sexual intercourse with male injecting drug users.

"Of the Nation’s 72.3 million minor children in 1999, 2.1% had a parent in State or Federal prison. Black children (7.0%) were nearly 9 times more likely to have a parent in prison than white children (0.8%). Hispanic children (2.6%) were 3 times as likely as white children to have an inmate parent.“

"In spite of the medical advances in AIDS treatment, AIDS was still a leading cause of death for African American and Latina women age 25 to 54 in 2000. AIDS was among the top five leading causes of death for African American women and was among the top seven leading causes of death for Latinas. Over 60 percent of those AIDS deaths were injection-related."

Women of Color and HIV/AIDS

HIV/AIDS: Substance- not solely injection-related; HCV Prevention and treatment; Prison as important source of infections; Increase access to Overdose Reversal and Prevention

resources & education; Eliminating the Drug War/Rockefeller Drug Laws; More drugs, bigger quantities, lower prices, & by design:

Legalize, Regulate, & Tax; Educate and norms will develop;

Act on the growing pollution of drug care by penal system; Harm Reduction is now a paradigm shift w/in drug

treatment;

Promote new & varied substitution therapies.

Reform your view of Anger—science has; Reform your view of Cells—science has; Reform your view of healing—science has; If the answer to structural poverty and

alienation lies within stronger, whole selves, then a new critique on the role of institutions in individual and family lives has to be on our agenda.

We are a coalition of humanists mobilizing our communities to end the HIV/AIDS pandemic. We are committed to addressing the injustices and disparities that fuel the spread of HIV/AIDS through the promotion of education, public policy, and corporate and social responsibility.