International Journal of Drug Policy - 2014

Volume 25 Issue 3 May 2014

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610 R. McNeil et al. / International Journal of Drug Policy 25 (2014) 608–615 practices (e.g., requiring help injecting), income-generating strate- gies (e.g., sex work), health status or disability, or social isolation potentially increased vulnerability to harm, including violence. Seven participants were recruited by referral from VANDU staff, while the remaining participants were recruited within the context of a larger ethnographic project based at VANDU. The majority of interviews (n = 20) were conducted at a storefront research office in the DTES, and the remaining interviews (n = 3) were conducted in an office at VANDU. Participants provided written informed consent prior to their interviews and received an honorarium ($20 CAD) following its completion. Interviews were audio recorded and averaged approximately 45 min in length. Interviews were transcribed verbatim and reviewed for accuracy by the lead author. Ethical approval for this study was obtained from the Providence Healthcare/University of British Columbia institutional research ethics board. We used an interview topic guide to facilitate discussion regarding how participants experienced place in the DTES, and how these experiences shaped their access to Insite. Given that local epi- demiological data indicated that men and women who inject drugs experience high levels of violence, we were particularly concerned with how the social geographies of our participants were shaped by violence and perceptions of safety, and included questions focusing on gendered and spatial dimensions of violence. Interviews were accompanied by a qualitative mapping exercise that sought to link diverse experiences (including violence) to specific locations in the neighbourhood. During the interview, participants and interview- ers made notes on neighbourhood maps to link diverse experiences and activities to specific locations. Participants were also asked to highlight areas that they perceived as safe or unsafe, including any areas in the neighbourhood that they avoided. Interview transcripts and maps were imported into NVivo (v. 9) to facilitate data management and coding. We used a multi-step process to analyze our data. We first analyzed maps to identify pat- terns in the socio-spatial practices of our participants. We reviewed each map individually while keeping detailed analytic notes, and then compared and contrasted these notes to identify spatial pat- terns. We noted that women and men had similar spatial patterns (e.g., avoided particular areas). We then developed a coding frame- work based on these socio-spatial patterns and a priori categories extracted from the interview guide (e.g., understandings and expe- riences of violence, perceptions of the neighbourhood, reasons for avoiding particular areas), and used this to code the interview transcripts. We then linked interview data to the mapping data to develop thematic descriptions of these socio-spatial patterns. We noted that participants' socio-spatial patterns were distinctly gendered, in that, while violence produced similar spatial patterns among women and marginal men, these were understood and pos- itioned differently. We adjusted our coding framework to account for these similarities and differences, and then recoded the data to establish the final categories. Finally, we drew upon concepts of everyday, structural, and symbolic violence, and hegemonic masculinity, to situate the spatial practices of our participants within their gendered social and structural contexts. We then pre- sented our final themes (i.e., contextualizing gendered violence and masculinity in the DTES; gendered violence and geographical restrictions; locating survival in the street-based drug scene; and, crossing boundaries) to the VANDU Board of Directors to solicit their feedback and ensure the reliability of our themes. Results Sample characteristics The twenty-three individuals participating in semi-structured interviews included eleven women and twelve men. All of the men interviewed were identified as 'marginal men' insofar as they reported characteristics that diminished their status within the drug scene, including but not limited to: physical disabilities (n = 4); requiring help injecting (n = 4); sleeping outside (n = 3); and, social isolation (n = 5). Participants averaged approximately 40 years of age (range 27–59 years), and eight self-identified as a member of a visible minority (Aboriginal ancestry, African-Canadian, or Indo- Canadian). Most participants (n = 20) indicated that they used drugs daily, with crack cocaine (n = 20), heroin (n = 12), hydromorphone (n = 8), and cocaine (n = 6) identified as the most commonly used drugs. All participants had lived in the DTES within the past five years, and nineteen currently lived there. Nearly half of our partici- pants were staying in emergency shelters (n = 8) or sleeping outside (n = 3), while the remaining participants reported that they lived in single room occupancy hotels (n = 6) or apartments (n = 6). Nearly all participants received income primarily from social assistance payments (n = 22), and most of the women (n = 8) reported regularly exchanging sex. Place, violence, and masculinity in the Downtown Eastside Central to participant narratives of place in the DTES were gen- dered experiences of drug scene violence. Nearly all women and marginal men specified locations where they had been "threat- ened" or "attacked", while those remaining spoke of locations where they had witnessed violence. Our findings demonstrate how the street-based drug scene was structured by a hegemonic form of masculinity predicated on violence and the subordination of women and marginal men. Women and marginal men were deemed to occupy lesser positions than 'dominant men' (i.e., drug dealers, "boyfriends", violent drug users, and other men occu- pying central positions of power within the street-based drug economy) within the gendered power hierarchy in the street- based drug scene. Participants indicated that women and marginal men had limited ability to protect themselves from violence and exploitation, and indicated that this increased their vulnerability to violence and marked them as the targets of predatory dominant men when entering drug scene milieus. One woman in her late fifties remarked: One guy's in a wheelchair and he's paralyzed on one side. He's been a heroin addict for thirty years and he had a stroke. . .Every time he used to go to the alley, he'd get ripped off, beaten up, lose everything. Women commonly spoke of the additional risks of violent sexual assault. For example, one woman in her late twenties who engaged daily in outdoor sex work noted: I'll smoke [crack cocaine] in the alley and I hate it. . .It's scary. Any- body could walk up behind you with something and beat you and try to rob you 'cause they want your drugs. It's just scary. . .I've been raped. [in an alleyway] Gendered violence was understood to be a natural consequence of drug scene involvement, and thus operated as a form of symbolic violence. Many participants expressed that this normalized, gen- dered violence was most evident in the expectation that dominant men would seek to control the money and drugs or labour (e.g., con- texts in which they exchanged sex) of women and marginal men. For example, as one older man noted during his interview: The girls make the money [through involvement in sex work]. Guys know they got the money. The guys don't make money, and that way they have to beg, borrow or steal in between cheques. . .So, of course they [women] are going to be manipulated. . .These guys,

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