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Miriam Boeri, Kennesaw State University,
and Jeff McDowell, Atlanta Harm Reduction Center
A multitude of intellectual discourses will be shared at the upcoming ASA Annual Meeting that appropriately addresses this year’s theme, Toward a Sociology of Citizenship: Inclusion, Participation, and Rights. However, this richly sociological theme is already embraced in all its potential application under the roof of a dilapidated old boarding house in Atlanta’s infamous drug market. It is here where a staff of five and a fluid number of volunteers put the lofty words "inclusion," "participation," and "rights" into action. Informed by years of harm reduction research, empowered by concerned professionals, and motivated by their awareness of the need, the grassroots movement known as the Atlanta Harm Reduction Center (AHRC) continues to address the needs of some of the most vulnerable populations in Atlanta. AHRC is an HIV/AIDS prevention and wellness program dedicated to empowering marginalized, at-risk individuals by addressing the health disparities of intravenous drug users (IDUs), multi-substance users, sex workers, and homeless transient people engaged in high risk behaviors.
[Zip code] 30318…One of the city’s poorest neighborhoods is a block-shaped section of the Westside known as The Bluff. Nearly 4,000 people live there, on the rough end of the wealth gap. Some parts of The Bluff look so third-world, you can hardly believe you’re in Atlanta. If you’re white and drive through, the people who live there assume you’re looking for drugs. If you’re looking for drugs, you’re in the right place. (Williams, 2009 from the Atlanta Magazine/KingFile)
AHRC volunteers and staff
at a needle exchange
Many mega-urban inner cities have their own lingo-labels for the impoverished area where drug addicts and sex workers are allocated to single-occupancy rooms or alleyways to perform their rituals. In New York City it was known as "the Bowery," in Vancouver it is "Downtown Eastside," in San Francisco it is the "Tenderloin District," and in Los Angeles this section of the city goes by the name of "Skid Row," a quasi-generic term used in other cities. Atlanta has its own unique spin on skid row, since the area known to some as "the Bluff" is also home to many long-term home-owner residents. An entry on Wikipedia calls this area "Atlanta’s only major open-air heroin market." The online wiki of modern English colloquialisms, Urban Dictionary, defines "the Bluff" as a specific area in Northwest Atlanta known for high crime and drug activity. Officially, the area is known as Vine City, although the street drug activity extends into an adjacent neighborhood called English Avenue. Even web-based forums post reference to the Bluff in chats on "copping dope" in Atlanta. In an effort to curb use of this derogatory label, local residents and community activists who live and raise families in the neighborhood would like to see the "Bluff" reference vanish from the vernacular. AHRC walks the fine line between collaborating with the local residents as they regain control of their neighborhoods while also delivering interventions and harm reduction services to those who gravitate to the community for what the neighborhood notoriously offers. AHRC succeeds in gaining the respect and trust of both long-term and transient residents.
Since 1998, AHRC, a community based 501(c)(3) organization, has been dedicated to empowering substance users, sex workers, the homeless and other people engaged in high risk behaviors with the goal of reducing or eliminating their chances of acquiring or transmitting HIV/AIDS, Hepatitis, STDs, and other communicable diseases. AHRC is the only HIV/STD and Hepatitis prevention and wellness outreach program in Georgia designed to meet the needs of active/chronic relapse substance users and others who are at high risk for HIV/STD and Hepatitis infection due to injection drug use and unsafe sexual practices. AHRC’s mission is to empower individuals currently engaged in high-risk lifestyles by providing them with options so that they can make healthier and safer life decisions using harm reduction strategies. In addition, AHRC advocates for the development of a comprehensive prevention and wellness approach to the health care needs of substance users, sex workers, and other marginalized populations. This includes treatment on demand, access to non-judgmental medical and social services, and the implementation of population-specific AIDS prevention programs such as needle exchange.
AHRC is located within one of the highest risk "Empowerment Zones" of metro Atlanta, Neighborhood Planning Unit-L (NPUL), at 472 Paines Ave., NW, Atlanta, GA 30318. This area is located five blocks from Downtown Atlanta. The urban residential communities of "English Avenue" and "Vine City" are home to hundreds of senior citizens, most of whom purchased their homes in the community over four decades ago. This affected area has more than 400 vacant properties and is home to many transient and homeless IDUs, sex workers, and multi-substance users. The residential community has constant traffic because of individuals seeking heroin and other drugs. Many drive to the Bluff from more than 20 counties within Metro Atlanta, and some travel from as far as Chattanooga, TN, to cop heroin. Often sharing needles and returning to their respective counties, state, and communities, they carry their high-risk behaviors back with them infecting others hundreds of miles from their point of initial infection and/or transmission.
Currently, the AHRC syringe exchange program provides direct services to at least 300 IDUs monthly. According to AHRC outreach databases, 94 percent of the consumers of these services are African American. Other data reveal that 69 percent of these marginalized individuals are recidivist, 61 percent are unemployed, 33 percent have known disabilities, 42 percent are HIV and/or Hepatitis C positive, 38 percent are women, 8 percent are IDU/MSM (men sleeping with men), and 2.5 percent transgender sex workers.
While AHRC started with a focus on needle exchange, currently they offer a tiered program that goes well beyond syringe exchanges. Activities include sponsoring women’s groups, men’s groups, and testing and counseling for HIV, TB, and syphilis. The staff provides food, showers, and clean clothing at the building and delivers food to home-bound neighbors. On request, AHRC staff provides referrals to substance abuse treatment, medical services, and methadone providers. Finally, in an effort to fulfill their mission statement to improve the wellbeing of marginalized individuals, AHRC staff is working hard to provide linkage to employment and housing. (See Atlanta Harm Reduction Center website, www.atlantaharmreduction.org/, for a full description of the tiered programs.)
Due to AHRC’s long-standing commitment to risk reduction and its presence within the community, the non-profit is in a unique position to advocate for and educate individuals about syringe exchange. Beyond direct services, AHRC is involved in collaborating with community leaders and education-based research projects to raise awareness among public officials and community residents regarding the need for harm reduction policy change. Through educational and awareness activities, AHRC addresses the lack of access to clean syringes for intravenous drug users in the state of Georgia and the health disparities of marginalized populations at increased risk of HIV infection and fatal overdose. Strategies are being developed now for a potential distribution program of naloxone (Narcan), an opioid antagonist, directly to drug users. To that end, improving cooperation with ambulance and police services is a work in progress for AHRC.
The social significance of a harm reduction approach to drug-use problems is thoroughly appreciated by most sociologists; however the unique approach of the AHRC staff in assuring the inclusion, participation, and rights of the most marginalized of citizens—destitute and homeless drug users—is worth our attention. Their community-based prevention and wellness intervention contributes to our united goal of meaningfully addressing contemporary social problems.
For individuals interested in harm reduction, plan to attend the ASA’s Annual Meeting session, Risk Reduction and the Atlanta Harm Reduction Center, being planned by the Regional Spotlight Committee. The session will give hands-on demonstration of harm reduction awareness activities by AHRC staff. And please join us for a tour of AHRC and the Vine City/English Avenue neighborhoods. See your ASA program and ASA website for details.
Atlanta Harm Reduction Center www.atlantaharmreduction.org/
Urban Dictionary www.urbandictionary.com/define.php?term=the+bluff
Williams, Paige. 2009. "30318 Excerpted from "Poverty By the Numbers," The King Files, Stories from Atlanta Magazine’s Archives. Retrieved March 6, 2010