1. Social Relationships and Harm Reduction Practice among Injection Drug Users in Nova Scotia Joanne Parker CPHA 2008 Annual Conference Halifax, NS June 1-4, 2008

2. Injection Drug Users in Communities Across Atlantic Canada (ICAC) CIHR-funded, 3 year project Atlantic Advisory Committee Social relationships Safer and unsafe practices Urban and rural Atlantic Canada

3. The ICAC Research Team (IDUs in Communities across Atlantic Canada) Investigators: Lois Jackson, Dalhousie University (Principal Investigator) Margaret Dykeman, UNB Jacqueline Gahagan, Dalhousie University Jeff Karabanow, Dalhousie University Collaborators: Mainline Needle Exchange Sharp Advice Needle Exchange AIDS Committee of Newfoundland and Labrador AIDS Saint John AIDS New Brunswick SIDA/AIDS Moncton AIDS PEI

4. Ethics and Limitations Confidentiality Limited sample

5. Data Collection: Nova Scotia In partnership with: Mainline (Halifax and mainland NS) Sharp Advice Needle Exchange (Cape Breton)

6. Participants 38 interviews in rural and urban NS 12 in Halifax, 7 in Sydney, 19 in smaller communities 23 male; 15 female Age 18-59 Length of time injecting – broad range

7. Participants * ”Some High School” includes 2 current students ** Post-secondary = university or trade school

8. Participants * Social Assistance includes Income Support, Disability, Pension and Worker’s Compensation * Informal economy includes panhandling, stealing, sex trade work, selling drugs

9. Helpful Relationships Peer support Needle exchange “I have other people that come to the house to use and get gear. So I like having clean gear all the time in the house, in case people do drop by”. [32- Male]. Interviewer: Do you have any non-IV-using friends? Participant: “Yes, I’ve got people at the [needle exchange] that, you know, if I needed to talk to someone… they don’t judge you. They don’t do nothing to you. They are the only ones I’ve got anyways”. [41-Female]

10. Harmful/less safe relationships Reliance on other users “You might share [paraphernalia] by doing a wash. You know, you’re hard up for dope. You are hard up to get something into you, and someone is not going to give you some, but they’ll let you play with their spoon where they cooked it up in”. [17- Male] [What would happen if you insisted on using your own gear?] “You might not get hit… You take what you can get and you don’t be too picky. You are not going to insult someone, right? If they are giving you something, you are not going to be, you know…” [15- Female]

11. Harmful/less safe relationships Stigma and social exclusion “I would never ever go to the Needle Exchange or nothing like that just in case people lurking, the way they look at you - you know, a needle user”. [30-Male]

12. Final thoughts… Joanne Parker Research Coordinator parkerj@dal.ca 902-494-7061 For more information visit: www.med.mun.ca/airn/pages/research.htm