How and why was your organisation established?
Prevencasa has been providing harm reduction services in Tijuana since the late 1990s and officially became a community-based organisation in 2007 to address the HIV and hepatitis C epidemics among people who inject drugs. Tijuana is a key transit point for drug trafficking to the United States. The “Zona Norte” neighborhood, where the community-based organization is based, is the tolerance zone or red-light district of the city and is home to atrisk populations, including deportees, migrants, sex workers, and a significant number of homeless people who inject drugs. Currently, Prevencasa operates as a community harm reduction clinic, offering basic health services, training for medical professionals, and partnerships with researchers to document evidence-based services accompanied by the community and the participation of peer promoters. The inclusion of the entire community has positively impacted the services offered by the organisation, as harm reduction is reaffirmed as a public health strategy, with a multidisciplinary approach in constant evolution.
What role did women have in the inception and growth of your organisation?
85% of the people who provide services identify themselves as women; doctors, nurses, social workers, community health promoters, and peer promoters. All of their contributions and work towards the community are translated into the services that are carried out every day, which contributes to prioritising gender responsive programming including women only service spaces.
Can you please describe why a women only safe consumption facility was opened?
Prior to opening “la Zona”, a process of community consultation identified the importance of a safe space for women given a common context of exposure to gendered verbal and physical aggression including sexual abuse and the absence of safe spaces for women who use drugs. Women also expressed concern to avoid harrassment at the hands of public security (municipal police, national guard, army). Accordingly, the overdose prevention site, “La Zona” in Tijuana, began operating in 2022, representing a critical gender responsive harm reduction service in one of the most challenging environments for women who use drugs in Mexico. This space is operated by and for women and trusted companions.
“La Zona”, which has multiple areas and services, came into being as a low-threshold community model to counteract some of the effects of the unregulated local drug market. The experiences of both the staff and the people who visit have been more than positive, affirming the need to provide a safe space where women can consume any substance without social pressure. Further, La Zona provides an injecting space where women can calmly administer substances in a sterile setting – a process that is not possible in the street context where ‘public security’ harrassment (detention, extortion, compulsory rehabilitation, and theft of belongings) are increasingly common.
Creating safe spaces for women who consume psychoactive substances entails inclusion of specific services since the impact of stigma and criminalisation is greater, while experiences such as sexual violence, social persecution, problems with authorities and some neighbours add to the layers of barriers to womens access to multiple services that need to be pro-actively overcome. Additionally, La Zona generates trust and empathy with harm reduction services; “you are not alone”.
What services does La Zona provide for women?
Together with injecting and smoking spaces and commodities, La Zona provides rest and recreation areas and a makeup space, a storage area for personal belongings, showers with soap and a change of clothes, primary medical care and counselling, rapid HIV, HCV and syphilis testing, overdose response kits / Naloxone, and adulterant detection strips (fentanyl /methamphetamine). Additionally, workshops are held on overdose prevention, human rights, self care and support for women. Since the beginning of the fentanyl crisis almost six years ago, the organisation has treated more than 1,000 overdoses. All services are free of charge.
Can you tell us a bit more about the programs designed for sex workers?
Within the program for sex workers, safer sex supplies are provided such as condom and lubricant packets, as well as workshops on the prevention of sexually transmitted infections, HIV, HCV and syphilis screening tests, pregnancy tests and specialised gynecological care once a month. Personalised care is important as many women involved in sex work are also consuming multiple substances such as heroin, synthetic heroin cut with fentanyl and methamphetamines. These intersections can put women at risk of overdose as well as physical and psychological violence. So tailored supplies and services are provided depending on the needs of each person.
Can you give us some advice on how to leverage social media to reach your community?
Social media is used as another means of communication and connection with the community, advertising the service elements, location and open hours. People who live in other parts of the city ask about specific services, prevention supplies, procedures and so on. Some women in the community do not trust institutions but have access to a mobile device and prefer to contact the organisation virtually. Therefore, there is effort and emphasis to ensure people know that personal information is handled in a confidential manner. As a tool, social media is also used to provide information about the changing substances on the local market, their risks and precautions to follow when consuming them, and how to access self-care tools such as fentanyl and xylazine detection strips and sterile materials for consumption.
