Sunday, September 28, 2014

Harm reduction modeling ~Sevan

TW for (casual, not in depth) mention of drug use/abuse, self harm, sexual activity, abortion.
Hey blog world! Long time no see. (My bad...) I've been very very busy with entering school, crafting and working. So I haven't been writing much. I'm sorry about that.
Something that I've become passionate about recently is harm reduction. So I wanted to talk to you, the reader, about what it is and where it can be applied.
First, just what is Harm reduction? According to Wikipedia it can be classified as:
"Harm reduction (or harm minimization) is a range of public health policies designed to reduce the harmful consequences associated with various, sometimes illegal, human behaviors. Harm reduction policies are used to manage behaviors such as recreational drug use and sexual activity in numerous settings that range from services through to geographical regions."

So this can have a broad scope and can be applied to work surround sexual activity risk, illegal drug use, alcohol use/abuse, self harm behavior, and many other public health concerns.

As some of you may know, I work in a queer youth center. This week, my college class intersected with my passion for youth. The class is for social workers and the discussion was about abortion access for minors. I felt as though we started at the wrong end of the discussion really. There was no lead up, or talk of other public policies that effect youth prior to them getting pregnant. I was shocked that we were just going to start at the abortion side of the issue.

I see safe, legal abortion as part of an overall harm reduction strategy. Though first we have to back WAY up and talk about access that youth have to research based, accurate information about their bodied and sex. As someone who works with youth, I hear what they learn about in class. I live in the liberal state of Washington (though not a particularly liberal side of the state...) and even still, the information youth have access to either has holes in it (no pun intended. Well, kinda intended.) is outright wrong, or was misheard. When I look at maps of the US that show what access youth have to medically accurate information about sex I'm appalled.

If information is incorrect or shame based are we really shocked that our next step in harm reduction, which is contraception and barrier (condoms, dams, etc.) access either isn't used, or isn't used correctly? If the only information you have about a condom is that it doesn't really work anyway, would you bother to use it? Research* shows that young people who have access to condoms and other barriers are NOT more likely to become sexually active, but those who are already sexually active are more likely to be safe about it. The logic that educating young people about sex will make them want to have sex also doesn't hold up. When people are treated with autonomy and respect to make decisions about their own bodies they are more likely to think through and make healthier choices.

So most states don't have good information in their schools about safer sex, they don't provide access to barriers or birth control (or if they do, we know there is limited information about those choices) and then we're going to be really disappointed when they become pregnant, become infected with STIs (at very high rates right now^) and/or are considering or having abortions.

If we want to lower pregnancies and abortion rates then we MUST provide lowest harm reduction strategies such as education. You can't provide NO harm reduction and expect no harm to come! It doesn't work that way.

I could tackle any harm reduction policy but that would end up with a very very long blog post. It all follows the same structure.

*Sources: Sally Guttmacher, et al., “Condom Availability in New York City Public High Schools: Relationships to Condom Use and Sexual Behavior,” American Journal of Public Health 87 (September 1997): 1427-1433; and Susan Blake, PhD et al., “Condom Availability Programs in Massachusetts High Schools: Relationships with Condom Use and Sexual Behavior,” American Journal of Public Health 93.6 (June 2003): 955-961.

^The CDC estimates that half of new STD infections occur among young people. Americans ages 15 to 24 contract chlamydia and gonorrhea at four times the rate of the general population, and those in their early 20s have the highest reported cases of syphilis and HIV. Young men and women are more likely than older people to report having no sex in the past year, yet those who are having sex are more likely to have multiple partners, which increases the risk of STDs.