The role of peer drug users’ social networks and harm reduction programs in changing the dynamics of life for people who use drugs in the downtown eastside of Vancouver, Canada
Notice bibliographique
Résumé
The Downtown Eastside (DTES) of Vancouver, Canada has been the epicentre of HIV, hepatitis C and drug overdose related to People who inject drugs (PWIDs) since the mid1990s. In response to the growing government inaction, numbers of peer-run organizations were formed. This dissertation was conducted to capture the genesis and influence of peer drug users, their networks and harm reduction programs over the past 18 years in shaping the neighborhood. Semi-structured qualitative interviews were conducted with peers from various harm reduction volunteer locations in the DTES. Moreover, various drug users were recruited from a controversial harm reduction program in the DTES that provides pharmaceutical heroin. Interviews were analyzed thematically using two methods of coding analysis.\tFindings suggest that peers were taking on important education and safety roles, and were able to alter the behaviour, attitude, and intention of injection drug users within the DTES area of the city. Further, peer injection drug users were able to reach individuals who were reluctant to seek medical help, housing, and prevention services. Peers serve as an agent of change in the DTES to disseminate information and risk reduction skills to the most marginalized people. Peer drug users have not only been able to change the discriminatory rhetoric but they have been able to reduce the suffering that drug users have endured as a consequence of the war on drugs. Attending heroin trials in Vancouver has been particularly effective in creating a unique microenvironment where PWIDs who have attended heroin trials have been able to form a collective identity advocating for their rights. In physical terms, the DTES has become cleaner and safer for its residents because of availability of an injection facility and numerous peer-run harm reduction programs. In conceptual terms, PWIDs are less likely to experience discrimination by the city, hospital, and police. Moreover, the residents in the new DTES are more likely to be involved in their civic issues and raise concerns in a new political arena. Peer-run harm reduction programs have given a voice to the most marginalized members of society who otherwise would not be represented. The result of this dissertation and costing analyses conducted point to the need for the expansion of the peer and harm reduction programs beyond the current location in the DTES to other locations in Canada such as Montreal, Ottawa, Toronto, Saskatoon and Victoria.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,014 | 0,005 |
| Communication savante | 0,005 | 0,002 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».