Nina Grossman speaks out for people who oftentimes don’t have a voice in public or political discourse: people who use injection drugs. She’s been an avid educator and advocate for over 20 years, helping to ensure that people who use drugs can get access to the health resources and information they so desperately need. And importantly, that they can do so in a way free from judgment and shame.
Grossman started her work in HIV prevention, care, and education back in the early days of the epidemic.
“I’ve lived [in San Francisco] since 1983. And so anybody with any sense of community at all was dealing with HIV at the time, whether infected or affected. Our community was dying. So that was always a part of me. I just didn’t know my work was going to take me there.”
Her work took her—after a stint tending bar, working “crazy jobs with crazy hours,” and making a change in her drug use—to an internship with Marin AIDS Project. There, she worked with inmates at the nearby San Quentin State Prison. Grossman created a peer education program for inmates living with HIV. She conducted trainings to teach inmates about sexual health and HIV transmission and prevention. She also worked with inmates living with HIV to ensure that they were linked to health care services before being release from prison.
She points to this experience, in particular, as the catalyst for the rest of her life’s work with people who inject drugs to prevent HIV and hepatitis C. “It’s what really set me off—it set me on this path I didn’t know I was going to be on. But I’ve carried that experience with me.”
Her expertise in harm reduction—meeting people where they are to help them be safer, whether or not they ultimately change their risk behaviors—took her to San Francisco AIDS Foundation, where she led the volunteer-based HIV prevention programming as director of community-based programs.
She started work with the HIV Prevention Program, which is now called Syringe Access Services, in the late nineties, when providing safer drug injecting supplies meant working on the fringes of legality.
“At the time, we had some agreements with the police, but nothing was really in writing. There was still this underground mentality—most of the [needle exchange] sites were out in the streets and in alleyways. San Francisco AIDS Foundation created a separate 401(c)(3) [for the syringe exchange program] so the money for the foundation wouldn’t be in jeopardy if the cops came to shut the program down. There was uncertainty.”
Grossman, along with others at the foundation, saw an opportunity to bring needle exchange above ground.
She conducted surveys with clients to understand what they needed and wanted from a needle exchange site—what neighborhoods they wanted the site to be in, and what times were best for them. She helped to establish and scale up the services provided at ten sites across the city.
“We really tried to use input from people who wanted our services, so we weren’t just like, ‘we’re here because it’s convenient for us.’ We found other community organizations where we could rent out the space at night time.” After finding site locations, she helped bring other services to the exchange sites, such as case management, wound care and hygiene supplies, and testing for hepatitis C and HIV.
“It was kind of like a one-stop shop where the mentality was, ‘we’re going to treat you like any other patient or client.’ You’re coming here for your health, and we’re going to support you in as many ways as possible.”
Grossman also worked with the police department and the local health department to write a memorandum protecting needle exchange sites and their clients. This was no small feat.
She says she was lucky that, at the time, the police captain she worked with was “very liberal.” Believing in the resources provided by Grossman and her staff, he saw the syringe exchange sites as a true public health service benefiting not only clients but the community, too. The final memorandum she helped establish clarified that the police wouldn’t harass needle exchange clients or confiscate their syringes.
She helped publicize this agreement at syringe exchange sites and among clients, providing written documentation and stickers that people could show to police who weren’t aware of the memorandum. But her education about the services continued. “It was a big job,” she remembers.
“I had to meet with every police captain where our syringe sites were located, every month. Because if I was getting reports from the sites that officers were harassing them, or if exchangers were reporting that their syringes were getting confiscated, I would go and actually talk to the police captains. But the police chief was behind us—so ultimately people supported us.”
Grossman’s prior work in the prison system likely enabled her to deftly navigate this tricky political space—between a controversial public health initiative and the law.
“I worked with correctional officers, and prison staff, and the warden. I was able to talk one language with inmates or clients—and then on a very different level with the correctional officers. You just have to turn off the advocacy when you’re dealing with the police, and really focus on public health. They want to know, ‘how is this serving the community?’”
And she was able to tell them, easily. You can hear the passion Grossman has for her life’s work when she describes the benefits of needle exchange. She defends the rights of all people to be able to access safer injections supplies—free from judgment, stigma, and shame—and emphasizes all the benefits that established needle exchange sites can provide.
“Syringe exchange is just like anything else that people do for their health. When people get to know you, and trust you, they might share some other things. They’re doing something for their health, and we support them in as many ways as possible. Sometimes all they want is a smile—but sometimes they want to ask you about HIV and hepatitis C. And still in my volunteer work I do a lot of education. And people really appreciate it.”
Although Grossman has moved on from her role at the foundation—serving on the Mayor’s Task Force on Hepatitis C for two years and also working as a community liaison manager for a pharmaceutical company—she hasn’t stopped volunteering at the foundation’s syringe access services location on Sixth Street. “Whenever I can, I volunteer. I still see some clients who I knew from San Quentin in the early nineties! I have people come up and hug me when I work. I’ve known some of these people for years. Syringe exchange will always be my passion.”
Are you inspired by Nina’s work to bring syringe exchange above-ground? Share your appreciation for Nina’s advocacy, education, and volunteering in the comments below!
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