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FAQ

What is “harm reduction”?

Harm reduction is a set of practical strategies that reduce negative consequences of drug use, incorporating a spectrum of strategies from safer use, to managed use to abstinence. Harm reduction strategies meet drug users "where they're at," addressing conditions of use along with the use itself.

Because harm reduction demands that interventions and policies designed to serve drug users reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction. However, HRC considers the following principles central to harm reduction practice.

• Accepts, for better and for worse that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.
• Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others.
• Establishes quality of individual and community life and well-being--not necessarily cessation of all drug use--as the criteria for successful interventions and policies.
• Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.
• Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.
• Affirms drugs users themselves as the primary agents of reducing the harms of their drug use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use.
• Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people's vulnerability to and capacity for effectively dealing with drug-related harm.
• Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use

What’s the difference between “needle exchange” and harm reduction?

Needle exchange--the provision of clean hypodermic syringes in exchange for used ones--is probably the harm reduction strategy that is best known to the general public.  But it is only one of numerous strategies employed to improve the physical and mental health and life prospects of drug users and others who engage in activities that put them at risk of contracting HIV/AIDS and other infectious diseases.  In addition to needle exchange, PHP delivers other harm reduction strategies, including mental health services, support groups, HIV and Hepatitis C testing, education and follow-up and case management assistance.

Has the harm reduction approach to HIV/AIDS prevention been evaluated?

Over the years there have been numerous evaluations of needle exchange programs in New York City and throughout the world.  The overwhelming consensus among researchers and public health officials is that needle exchange has been proven to reduce the spread of HIV/AIDS and other blood borne diseases without increasing drug use.  (See our “Resources” page for more information about research findings).   In 1992, 50% of intravenous drug users (IDUs) in New York City were HIV positive and 4% were infected per year.  By 2002, after a decade of needle exchange, 18% of IDUs were HIV positive and the infection rate had dropped to 1% per year.

There is also a growing body of research that shows that harm reduction programs like PHP make a positive difference in the lives of participants overall.  For example a 2004 study which closely examined the experiences of 200 clients of a Bronx-based agency very similar to PHP concluded: 

“The present study, though preliminary in nature, provides positive results that associate harm reduction programming with incremental and life sustaining changes in drug users lives. These findings, along with those that have shown the positive effects of syringe-exchange interventions in reducing the transmission of HIV and other blood-borne viruses, demonstrate that harm reduction programs are a viable and promising approach to working with highly marginalized drug users.”   http://www.harmreductionjournal.com/content/1/1/7

Who are PHP's clients?

PHP has more than 8,000 clients.  They include intravenous drug users, sex workers, men who have sex with men, transgender people, people who have experienced chronic or episodic homelessness, people with serious and persistent mental illness, and people with histories of incarceration.  PHP was founded with the expressed purpose of serving this hard-to-reach and hard-to-retain client population. 

PHP’s clients reflect the racial and ethnic diversity of New York City:

36% are African American
33% are white
31% are Latino

69% are men
24% are women
7% are transgender

24% are between the ages of 20-29
35% are between the ages of 30-39
32% are between the ages of 40-49
9% are over the age of 50

Where does PHP's funding come from?

The bulk of our funding comes from contracts we have with the state, local and federal governments.  Our funding agencies include the federal Centers for Disease Control, the New York State Department of Health, and the New York City Human Resources Administration.  PHP also receives funding from institutional donors (foundations and corporations) and from individual contributors. 

PHP peer educator presenting at the Safe Injection Site conference