Harm Reduction is the policies, strategies, and programs focused on reducing the harms caused by social, medical, and environmental inequalities which influence how people engage in higher risk activities associated with sexual activity and substance use.

Principles

SafeLink Alberta is grounded in a framework of harm reduction which guides the development and implementation of all programs and services. Although the theory of harm reduction is traditionally rooted in supporting people who use substances, the principles of harm reduction transcend substance use and benefit all members of our community. SafeLink Alberta utilizes this framework to reduce negative consequences or potential harms seen within the lives and experiences of the people we serve while working to build relationships and improve health outcomes.

SafeLink Alberta’s framework of harm reduction is based on 7 key principles which shape and
inform our work:

1. Harm Reduction is an evidence-based public health approach.

Harm reduction is a public health approach aimed at preventing HIV, hepatitis C, and other sexually transmitted and blood-borne infections. This framework recognizes that complex social structures, such as poverty, classism, racism, white supremacy, colonization, trauma, social isolation, health inequities, sex-based discrimination, and other social inequalities influence health outcomes for individuals. These forces affect people’s vulnerability to, and capacity for, navigating the harms that may be associated with their experiences.

As a public health approach, harm reduction implements evidence-based policies, programs, and practices focused on reducing the health, social, and economic consequences often associated with these experiences of harm, while systemically advocating for changes to health inequities caused by social determinants of health.

2. Harm Reduction promotes human rights.

The foundation of harm reduction is rooted in dignity and human rights for everyone, as outlined by the United Nations Universal Declaration of Human Rights. Harm reduction recognizes that agency, choice, and autonomy are basic human rights that are often threatened by larger structural forces. In practice, a harm reduction framework promotes human rights by advocating for basic needs including food, clothing, safety, stable housing, access to health care, education opportunities, and social support and inclusion for all people, without discrimination or prejudice.

3. Harm Reduction focuses on reducing harm.

Harms exist within all aspects of the human experience. A harm reduction framework doesn’t focus on abstinence or ceasing certain activities, but rather on working with individuals and their communities to minimize any negative health or social outcomes associated with these activities to
improve their overall quality of life. This approach does not seek to ignore or mitigate the realities of harm associated with certain experiences. It does, however, encourage self-empowerment by meeting people where they are at, sharing education and resources, building relationships, and promoting autonomy so people can make informed decisions and lessen potential harms to self and the broader community.

Harm reduction also acknowledges that, due to inequitable social determinants of health, harms associated with sexual activity and substance use are not experienced equally across all populations. Stigma, social and institutional discrimination, and punitive legislation disproportionately impact vulnerable and/or marginalized community members. Harm reduction works to counter these systemic level harms by challenging policies and practices that perpetuate social inequities through community collaboration, education, and advocacy work.

4. Harm Reduction is pragmatic, practical, feasible, safe, and cost-effective.

Harm reduction centres on practical ways to help reduce potential harms associated with individual experiences and behaviours. Harm reduction supply distribution, including sterile syringes and pipes, naloxone kits, and safer sex supplies, combined with accessible education focused on safer ways to use these items, is proven to be an effective strategy to reduce disease transmission within our communities.

5. Harm Reduction prioritizes the meaningful engagement of people with lived/living experience.

Harm reduction is a transparent and accountable, community-driven approach that focuses on the active participation of people with lived and/or living experience, alongside community stakeholders, to shape policies, practices, and programs. Harm reduction recognizes that people are experts in their own lives and their own experiences and that, when offered meaningful engagement opportunities, that expertise can be used to create impactful change within their community.

6. Harm Reduction is non-judgemental and value neutral.

Harm reduction uses a non-judgmental approach that treats every person with dignity, compassion, and respect, regardless of circumstance or condition. Harm reduction does not impose individual values or social ideology related to morality onto others but uses evidence- based best-practice to inform the work.

Harm Reduction is adaptive and innovative.

A harm reduction framework recognizes that individual change is not a linear process, but a dynamic, incremental evolution of self-discovery and transition. Therefore, an adaptive and innovative response from service providers must be continually practiced to effectively meet community members where they are at during each stage of their journey.

References:
Denis-Lalonde, D., Lind, C., & Estefan, A. (2019). Beyond the buzzword: A concept analysis of harm reduction. Research and Theory for Nursing Practice, 33(4), 310–323. https://doi.org/10.1891/1541-6577.33.4.310

Hawk, M., Coulter, R. W., Egan, J. E., Fisk, S., Reuel Friedman, M., Tula, M., & Kinsky, S. (2017). Harm reduction principles for healthcare settings. Harm Reduction Journal, 14(1). https://doi.org/10.1186/s12954-017-0196-4

United Nations. (1948). Universal declaration of human rights. Retrieved October 2021 from https://studenthelp.secure.griffith.edu.au/app/answers/detail/a_id/2863/~/how-do-i-cite-the-un-universal-declaration-of-human- rights-in-apa-style%3F

Decriminalization of Sex Work:

Position: SafeLink Alberta supports the decriminalization of sex work and opposes the continued implementation of Bill C-36, Protection of Communities and Exploited Persons Act and sections of the Immigrant and Refugee Protection Regulations in addition to all other municipal, provincial, and federal legislation that imposes violence on sex workers.
As an active member of the Canadian Alliance for Sex Work Law Reform (CASWLR), SafeLink Alberta (identified under the program name Shift, Calgary), supports and continues to advocate for the 49 recommendations for law reform as outlined in the CASWLR’s Safety, Dignity, and Equality: Recommendations for Sex Work Law Reform in Canada (2017).

Decriminalization of HIV Non-Disclosure:

Position: SafeLink Alberta supports the decriminalization of HIV non-disclosure. SafeLink Alberta believes that people living with HIV and other sexually transmitted and blood-borne infections should be offered support, equitable access to treatment, and provided the resources needed to feel empowered to take control over their sexual health, rather than threatened with punishment under Canada’s Criminal Code for non-disclosure of their HIV status.
SafeLink Alberta supports the Canadian Coalition to Reform HIV Criminalization (CCHRC), a national coalition comprised of people living with HIV (PLWH), community organizations, academics, and lawyers (CCRHC, 2022) and endorses their calls to reform Canada’s Criminal Code and enact other changes to HIV criminalization as outlined in Community Consensus Statement: Change the Code, Reforming Canada’s Criminal Code to Limit HIV Criminalization.

Decriminalization of Personal Drug Possession:

Position: SafeLink Alberta supports the decriminalization of drug possession for personal use. SafeLink Alberta believes that substance use should be approached from a public health and human rights lens and that Canada’s existing punitive drug laws are causing extreme harms within the community.
SafeLink Alberta supports the Canadian Drug Policy Coalition, and its supporting members, in their advocacy work for decriminalization of substances in Canada as outlined in Decriminalization Done Right: A Rights-Based Path for Drug Policy. In alignment with this document, SafeLink Alberta’s support extends beyond decriminalization of personal drug possession to include national provision of low barrier access to safe drug supply, expungement of previous convictions related to personal drug possession; equitable access to harm reduction services including recovery and treatment services, supervision consumption sites, and harm reduction supplies; prevention programs focused on addressing inequities and social determinants of health; anti-stigma and public awareness campaigns to support the shift in social attitudes towards people who use substances; and a National Strategy to address problematic substance use throughout Canada, designed through meaningful consultation and engagement of people with lived and/or living experience and allies.

Undetectable = Untransmittable: 

Position: SafeLink Alberta supports the Government of Canada, the World Health Organization, and the global HIV Community in their call for a global declaration of Undetectable = Untransmittable. We acknowledge that the science is clear; an individual living with HIV, when taking their medication as directed by their physician, can achieve, and maintain an undetectable viral load. Once an undetectable viral load has been achieved, the HIV virus cannot be transmitted to sexual partners.