Boyd Jade, Lavalley Jennifer, Czechaczek Sandra, Mayer Samara, Kerr Thomas, Maher Lisa, McNeil Ryan
British Columbia Centre on Substance Use, St. Paul's Hospital, 400 - 1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
British Columbia Centre on Substance Use, St. Paul's Hospital, 400 - 1045 Howe Street, Vancouver, BC V6Z 2A9, Canada.
Int J Drug Policy. 2020 Apr;78:102733. doi: 10.1016/j.drugpo.2020.102733. Epub 2020 Apr 2.
Attention to how women are differentially impacted within harm reduction environments is salient amidst North America's overdose crisis. Harm reduction interventions are typically 'gender-neutral', thus failing to address the systemic and everyday racialized and gendered discrimination, stigma, and violence extending into service settings and limiting some women's access. Such dynamics highlight the significance of North America's first low-threshold supervised consumption site exclusively for women (transgender and non-binary inclusive), SisterSpace, in Vancouver, Canada. This study explores women's lived experiences of this unique harm reduction intervention.
Ethnographic research was conducted from May 2017 to June 2018 to explore women's experiences with SisterSpace in Vancouver's Downtown Eastside, an epicenter of Canada's overdose crisis. Data include more than 100 hours of ethnographic fieldwork, including unstructured conversations with structurally vulnerable women who use illegal drugs, and in-depth interviews with 45 women recruited from this site. Data were analyzed in NVivo by drawing on deductive and inductive approaches.
The setting (non-institutional), operational policies (no men; inclusive), and environment (diversity of structurally vulnerable women who use illegal drugs), constituted a space affording participants a temporary reprieve from some forms of stigma and discrimination, gendered and social violence and drug-related harms, including overdose. SisterSpace fostered a sense of safety and subjective autonomy (though structurally constrained) among those often defined as 'deviant' and 'victims', enabling knowledge-sharing of experiences through a gendered lens.
SisterSpace demonstrates the value and effectiveness of initiatives that engage with socio-structural factors beyond the often narrow focus of overdose prevention and that account for the complex social relations that constitute such initiatives. In the context of structural inequities, criminalization, and an overdose crisis, SisterSpace represents an innovative approach to harm reduction that accounts for situations of gender inequality not being met by mixed-gender services, with relevance to other settings.
在北美药物过量危机的背景下，关注女性在减少伤害环境中受到的不同影响至关重要。减少伤害干预措施通常是“性别中立”的，因此未能解决延伸至服务场所的系统性及日常的种族化和性别化歧视、耻辱感和暴力问题，限制了一些女性获得服务的机会。这种情况凸显了北美首个专为女性（包括跨性别者和非二元性别者）设立的低门槛监督消费场所——加拿大温哥华的姐妹空间（SisterSpace）的重要性。本研究探讨了女性对这一独特减少伤害干预措施的生活体验。
2017年5月至2018年6月进行了人种志研究，以探索温哥华市中心东区（加拿大药物过量危机的中心）女性在姐妹空间的经历。数据包括100多个小时的人种志田野调查，其中有与使用非法药物的结构脆弱女性进行的非结构化对话，以及对从该场所招募的45名女性进行的深入访谈。通过演绎和归纳方法在NVivo中对数据进行了分析。
该场所（非机构性）、运营政策（禁止男性进入；具有包容性）和环境（使用非法药物的结构脆弱女性的多样性）构成了一个空间，使参与者能暂时从某些形式的耻辱感和歧视、性别暴力和社会暴力以及与毒品相关的危害（包括药物过量）中得到缓解。姐妹空间在那些常被定义为“越轨者”和“受害者”的人群中培养了一种安全感和主观自主性（尽管受到结构限制），使她们能够通过性别视角分享经验知识。
姐妹空间证明了那些超越通常对药物过量预防的狭隘关注、考虑构成此类举措的复杂社会关系的社会结构因素的举措的价值和有效性。在结构不平等、刑事定罪和药物过量危机的背景下，姐妹空间代表了一种创新的减少伤害方法，该方法考虑到了男女混合服务无法满足的性别不平等情况，对其他场所也具有借鉴意义。
