Negotiating Care and Control: Women's Experiences of Two Harm Reduction Services in Copenhagen.

Abstract

In this paper, we build on literature examining care practices in harm reduction services to investigate some of the reasons why women who use drugs access, remain in or leave harm reduction services. Through the analysis of ethnographic fieldwork collected at two Danish harm reduction services, including 29 interviews with women who use drugs, this study examines how care is practised in these services, what conditions these practices and how women are affected by this care. Our findings indicate that care is enacted in material, social and affective practices and relations, including the provision of everyday necessities, bodily affection and staff expressions of concern and sympathy that promote belonging. However, these care practices are also conditioned by relations of control mediated by workplace factors, the impacts of national and organisational policies including ongoing resourcing challenges, staff understanding of care practices and intersecting dynamics of gender, ethnicity and class. Women's experiences of harm reduction services are mediated by their everyday struggles negotiating relations of care and control with significant implications for both the quality of care delivered in these sites and its impacts. We close by reflecting on the tensions between care and control in harm reduction programmes for women.