Harm Reduction and Help Seeking
Harm Reduction and Help Seeking
This chapter contends that alliance positioning of street-involved women as damaged by dysfunctional families and communities neglects the structural forces that inform the women’s everyday lives. Resulting attempts to provide therapeutic services, while intended to address the complex reasons why women struggle with substance abuse, homelessness, and involvement in sex work, focus almost exclusively on women’s individual decision making. This focus fails to acknowledge that sex trading is itself a help-seeking strategy for women that allows them to meet their immediate needs without facing restrictive services provision conditions that often include lengthy wait lists, mandatory self-disclosure, and abstinence from illicit drug use. Many alliance professionals, particularly those who work directly with street-involved women, readily acknowledge the limitations of these prevailing approaches, and yet they remain bound by systemic constraints that position the women’s collective struggles as individual problems. Chapter subsections specifically address prevailing conceptions of help and harm reduction in social sciences and public health literature; present quantitative data on the women’s housing, formal education, and employment and health histories; and describe women’s perspectives on their needs and harm-reduction strategies, as well as alliance professionals’ perspectives on the women’s needs.
Keywords: families, harm reduction, employment, health, systemic constraints
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