PDIS: People Doing Interesting Stuff

In the superheroes' pantheon of African-American HIV and harm reduction activists and workers, you can think of Tracie Gardner was one of the Golden Age figures. In this episode of PDIS, we learn about Tracie's origin story, what it was like to watch the HIV/AIDS crisis unfold in Black America in the 1980s and 1990s, why she got involved in the work, and how she came to harm reduction.

In this episode of PDIS: People Doing Interesting Stuff, I talk to Deon Haywood, the Executive Director of Women With A Vision, Inc. (WWAV). Founded in 1989 by a grassroots collective of Black women in response to the spread of HIV/AIDS in New Orleans, Louisiana, Women With A Vision is a social justice non-profit which focuses on the most urgent issues faced by women, especially women of color vulnerable to criminal justice involvement. Originally focusing on health promotion and community outreach, Women With a Vision over the years has expanded its activities to include policy-level initiatives to address various forms of structural violence that negatively affect women and communities of color within Louisiana and elsewhere. Today their major areas of focus include Sex Worker Rights, Drug Policy Reform, HIV Positive Women's Advocacy, and Reproductive Justice outreach.

Their mission statement says "We envision an environment in which there is no war against women's bodies, in which women have spaces to come together and share their stories, in which women are empowered to make decisions concerning their own bodies and lives, and in which women have the necessary support to realize their hopes, dreams, and full potential."

In the late 1980s, Howard Josepher and Joe Turner met in New York City and began the program now known as Exponents. Their goal was deceptively simple, to establish an outreach and recovery program for people returning home from prison with a substance use problem. But it was actually more complicated than that. Although they had some federal funding to run a limited three-year program, when that money dried up they were left with a program which had promise but few resources. Furthermore, there really weren't that many existing models for this kind of work. Many of their first participants had been recently diagnosed with HIV, and all were at some risk for contracting the virus. Meanwhile, in the late 1980s and early 1990s, neither the formerly incarcerated nor people who used drugs were viewed with much sympathy. Parole programs weren't always that helpful, and addiction programs required drug abstinence above all else in exchange for services. Howie's and Joe's vision of harm reduction-based recovery -- emphasizing stability and wellness first, not abstinence -- was well ahead of its time. So, too, was the program model, which is an 8-week course of classes (three courses a week) on how to begin one's recovery.

They called it ARRIVE, which originally stood for AIDS Risk Reduction for Intravenous Drug Users and Ex-Offenders (that language is a little dated, and the program todays does much mx`ore than the title implies). ARRIVE isn't a "28-day cure," and they don't even require participants to always be sober while they're in the course. Instead, Exponents (self-described as "a client-driven organization rather than program driven") focuses on providing participants the tools to re-build their lives and the network (currently some 10,500 Exponents alumni) of other people in post-incarceration recovery. The theory is that if you welcome everyone and just get them in the door to commit to 24 classes, that constitutes a major first step for individuals who have a long road to travel. 75% of enrollees complete the course and most of those go on to get into recovery, get their health back on track (a major challenge, especially for people with HIV and substance use problems), and to rebuild their lives. Most of the staff are ARRIVE alums, hired under the theory that, as Howie explains, "the person who's been down and out, and just getting out of prison, and may be on his way or her way to getting strung out again, looks at that person and says, 'if they can do it, I can do it, too'."

The ARRIVE program is the nation's oldest harm reduction program, and is Exponents' flagship program. Over the past three decades, however, they also have developed a range programs and services in support and counseling, homeless services, addiction treatment, peer training, HIV testing, HCV services, outreach to sex workers, recovery support services, GED training, and pre-release and re-entry services for returning citizens.

Nearly thirty years after Howie and Joe started their work in the basement of a church, they sat down with me in one of their conference rooms to explain to me how they put the whole thing together.

The "harm reduction as resistance" edition (with Joyce A. Rivera). Welcome to PDIS. A week after the Trump election of November 2016, Joyce Rivera, the founder and Executive Director of the St. Ann's Corner of Harm Reduction, joined me and my students at the PDIS studios. This was a few days after the federal election of 2016, which put Donald Trump in office, and Joyce explained to me why she's optimistic about the future. A lot of her optimism for the future stems from her work in the past. Rivera was an early researcher and activist in harm reduction and drug use policy, working in the 1980s and 1990s, a time when we knew little about the lives of people who used drugs, and when most people didn't care to know. In comparison to thirty years ago, Rivera believes, doing harm reduction in Trump's America won't be nearly as difficult. She also talked with me about what it was to do that work in the first decade of HIV, how she got into the work, and her perspective on why so-called "tough love" so often fails as a therapeutic and recovery strategy.

Joyce A. Rivera is the founder and Executive Director of Saint Ann's Corner of Harm Reduction (SACHR), and an adjunct professor at John Jay College of Criminal Justice, teaching a course on drug use and abuse. She has over thirty years of experience in program development and social services delivery, and has worked in harm reduction since 1990. As a consultant and grant writer, her expertise in HIV prevention and harm reduction has made her a local and national leader in the field of AIDS and drugs. She is a founding member of the National Harm Reduction Coalition (HRC), the North American Syringe Exchange Network (NASEN), and the Harm Reduction Care Network of New York (HRCNNY). Joyce frequently presents and conducts training on drug policy, harm reduction, women, communities of color, and social justice. She has chaired the boards of HRCNNY and the Latino Commission on AIDS. Joyce holds a bachelor of science degree in health administration with a specialization in healthcare planning and a master's in comparative political science.