In Oblivion: Rural Injectors in Puerto Rico... A Whole lot of NADA

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Camila Gelpi-Acosta July 2008 CHAMP HIV Prevention Politics Forum at the NYC LGBT Community Center

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In OblivionRural Injectors in Puerto

Rico... A Whole lot of NADA

Camila Gelpí-AcostaNDRI, Project Director

July 2008A CHAMP Dialogue

The LGBT Community Center

Puerto Rico

How we startedHow we started

In June 2007, concerned NYC-based minority advocates responded to the public health crisis by creating the first rural-specific Syringe Exchange Program (SEP), “El Punto de la Montaña”.

How we started (cont’d)How we started (cont’d)

Funded by TIDES Foundation, an funneling monies via Bronx-based SEP CitiWide Harm Reduction, the project began operations in Cayey, Puerto Rico in January 2008.

Ongoing support from the Harm Reduction Coalition, Unidos Dándole Cara al SIDA (UDCAS-NYC Chapter) and PRConcra have provided us with the needed support to sustain operations.

Background

AIDS in Puerto RicoAIDS in Puerto Rico

In Puerto Rico, there are approximately 35,000 people living with HIV/AIDS and at least 50% of these are due to injection drug use. (www.tendenciaspr.com)

Some studies suggest these figures are actually higher (up to 75%). (ARRIBA, NDRI)

Syringe Exchange and other harm reduction programs are scarce.

A culture of blatant apprehension for injection drug users.

AIDS in Puerto Rico (cont’d)AIDS in Puerto Rico (cont’d) As it has always been, migration to NYC is still

the alternative for many. Over 10 years of struggle with the Puerto Rican

government and its inability to administer AIDS monies soundly.

In 2007, hundreds of People Living with HIV/AIDS were placed on a medications’ “waiting list”.

Advocates both in Puerto Rico and NYC raged the scenery demanding action from both Federal and National authorities.

AIDS in Puerto Rico (cont’d)AIDS in Puerto Rico (cont’d) Fund raisers, fax and phone blasts to the

legislature and executive offices in the island demanding improvement.

Advocates spread the frustration across the US, having the NY Times visit the island to cover the story.

Surreal: After all these chaos, last month the government of Puerto Rico had to return $28 Million HIV/AIDS to the Federal Government that went unspent. They just do not seem to get it.

Emergence of El Punto de la MontañaEmergence of El Punto de la Montaña

There is NO SEP in Puerto Rico that targets and aims to address the specific needs of rural injectors.

Most SEPs in PR are overwhelmed by lack of funding, understaffing and immense areas to cover (some cover more than 7 municipalities).

MisiónFirmemente basados en el hecho de que la salud es un derecho

inalienable de todo ser humano, El de Punto de la Montaña emerge como una riposta a la crisis de salud pública actual en nuestra isla, sobre todo en la montaña, el área más olvidada.

Inyectora/es de drogas conforman, precisamente en la montaña, la población en mayor necesidad. Utilizando un modelo de reducción

de daños, donde no dictamos juicios sobre las conductas que seres humanos asumen, la misión de El Punto de la Montaña es reducir los daños relacionados con el uso de drogas intravenosas entre inyectora/es en el área central de Puerto Rico. El objetivo

principal es disminuir la incidencia de VIH/SIDA y de Hepatitis entre nuestra/os inyectora/es rurales.

Prevención + Acceso = Poder.La salud es un derecho de toda/os… hagámoslo una realidad.

Emergence of El Punto de la Montaña Emergence of El Punto de la Montaña (cont’d)(cont’d)

Not surprisingly, there is a rampant lack of data or information of any sort around the needs of this specific population.

We are now attempting to do two things: Provide rural injectors with the tools that will keep them

safe from HIV and Hepatitis C; and Conduct research in order to fill the existing void that

prevents programs from going for more funding.

Bluntness speaks for itself

El Punto en la Montaña

Zero free syringes Zero cookers Zero ties Zero sterile water Zero opiate and cocaine overdose

prevention Zero proof of the need

ZERO

Target area: Cayey & Cidra (Demographics)

Age Range:18-24: 7%25-34: 31%35-49: 53%50+: 9%

Gender:Male: 87%Female: 13%

Housing status:Homeless: 31%Rental: 9%Housing Projects: 60%

Drug of Choice:Speedball: 98%Heroin: 2%

Demographics (cont’d) Access to needles:

Pharmacies: 27%

Streets: 59%

“Other”: 14% “Other” often means from Cockfight Arenas and/or diabetic

relatives or acquaintances.

Currently, 98 % are not getting services from any other SEP other than El Punto de la Montaña.

92% have NEVER heard of SEP prior to enrollment in El Punto de la Montaña.

All these we have done with…

An impossible budget of 17.5k/year 2 weekly events 2 underpaid part-time staff Volunteers from the University of Puerto Rico and

from NYC Our zeal to provide some relief

Where we are heading… In June 2008 El Punto de la Montaña was

incorporated; (Yes!) During the same month, UDCAS-NYC

supported our first attempt to assess the needs of these rural communities. 200 community needs assessments were administered.

We are about to start the process of data analysis.

Expand funding sources for harm reduction services development.

Ivette and Yaxza… rocking the boat

Shooting Gallery in Cayey: “Droga”

Entrance to the shooting….

Special Thanks

Yesenia Aponte Meléndez Edwin Santiago Gina del Pilar Arias Rosa Colón Ivette Rodríguez Fuentes Yaxza Velardo