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The LAist Interview: Shoshanna Scholar

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As part of LAist's commemoration of World AIDS Day, the LAist Interview this week features Shoshanna Scholar, Executive Director of Clean Needles Now. CNN is a grassroots needle exchange organization which also provides a range of crucial services related to HIV/AIDS prevention. Unlike other types of education and outreach efforts, Shoshanna’s line of work deals with one of the more controversial aspects of harm reduction programs. Shoshanna has much to report from the trenches of the AIDS crisis in Los Angeles. 1. Age and Occupation:

30 and I am the Executive Director of a non-profit needle exchange program.

2. How long have you lived in Los Angeles?

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I’ve lived here since December 1999

3. Where are you from?

I am from the Canadian prairie west - Regina, Saskatchewan

4. How has Clean Needles Now responded to the AIDS crisis specifically in Los Angeles?

In Los Angeles, needle exchange programs were started by artists, drug users and AIDS activists in the late 80s. These programs were a response to the lack of HIV/AIDS prevention services that were addressing the problem practically. Needle exchange programs recognize that abstinence isn’t an option for everyone and that people have a right to protect their own health and the health of their communities without exception.

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Needle exchange programs like mine, Clean Needles Now, strive to meet injection drug users where they are at- we work on Skid Row in downtown LA, near MacArthur Park, and on Hollywood backstreets. There are programs doing similar work all over the city. We recognize peoples’ privacy and so the program is completely anonymous, we are non-judgmental and do not make our services contingent on anything. We take in dirty needles for safe disposal and we give out clean ones. We also provide safer sex and injection equipment, information, and referrals.

Currently injection drug use is second only to sexual transmission of HIV. 30% of new HIV infections are due to sharing needles but the percentage is higher if you consider the number of cases related to drug users and their larger community, their families and sex partners.

In Los Angeles, needle exchange was made legal by a mayor’s declaration of a state of AIDS emergency in 1991. This year the city declared a new state of emergency to replace the old one. In 1994 the City started funding needle exchange programs through the office of the City AIDS Coordinator.

Through these city funded programs last year 11,000 people came to needle exchange programs (many of them were exchanging for other folks, as well.) 73% of the exchangers were male, 26% female, 1% identified as transgender. 35% were African American, 31% Caucasian, 28% were Latino. 79% report heroin as their drug of choice, and 14% report speed followed by speedballs (heroin and cocaine), cocaine, hormones, steroids etc.

One of the reasons that needle exchange is so valuable is because it reaches people who are often some of the most marginalized people in our society. For some people we are one of the only places that treat them with respect and recognize their dignity. This goes a long way. I have had people tell me that when they start by taking that step to take care of themselves by going to needle exchange, other parts of their lives start to change for the better. It can be the beginning point on a journey to affect positive change in our clients’ lives.

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5. As E.D. of Clean Needles Now, what types of tasks might an average workday require?

Most days, I go to an exchange site - that is a regular place where we meet clients who inject drugs and take in their dirty needles and in exchange give them clean ones. I work in three locations - Hollywood, Pico-Union (near MacArthur Park), and on Skid Row in downtown Los Angeles.

On Mondays, I get up at 7 or 8 and have a coffee with my partner Ben (bean) Adair and then hop in a car and head down to Skid Row to meet my outreach worker, Brian Lopez. I'm usually kind of late. We have a small clinic on the second floor of a building in a community garden/ soup kitchen run by the Catholic Workers. It is fucking cold in there. Brian and I get set up and wait the onslaught, which is actually kind of slow - about 40 or more folks in 3 hours.

People come in and tell us about their weekend if they're feeling talkative, or ask about some problem or other. They sometimes have legal problems, or problems with police harassment, sometimes they have serious skin infections or other health conditions, sometimes they want to go to drug treatment- you know - regular concerns. Not all of these things have to do with their drug use. Some of the problems they have are related to poverty or living outside. And still others are just the problems of a regular life- like loneliness, isolation, depression around the holidays.

We wrap up around noon and Brian and I have been on a major French onion soup kick. We prefer the soup at the Farmers Market on Fairfax and Third, but will take Taix if we are too lazy. Sometimes we go for burgers at Swingers. We tend to fight about everywhere else to eat and just meet up at the office afterwards.

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I work at home or go to the office and do regular office stuff - email, phone, whatnot. I do grant writing and IM my friends, and do a lot of dumb accounting. But some of the time I get caught up in these crazy political situations lobbying the mayor and city council people to make it easier to do my job or make life a tiny bit better for injection drug users. Some days are spent strategizing on what to do about police and legal problems. Lately I have been doing a lot of presentations- it seems like lots of people want to know about what I do.

Outreach is something I do in Hollywood and West Hollywood (but I'm not really supposed to be there since we are a Los Angeles-city funded program.) Outreach in this context means that I wander around to different bars, parks, diners, internet cafes, alleys etc looking for transgender folks - especially sex workers. When I find them I offer them stuff - condoms, information on HIV and Hep C and health issues of particular concern to them as trans folks and as sex workers.

I spend a lot of time talking with people when they have time for me. If they have questions about taking hormones (some buy black market stuff because they can't afford the prescriptions or the Dr. visits) and I try my best to answer them. Same goes for shooting drugs - I just try to answer without judgment. I end up doing a lot of referrals. I also end up doing a lot of gossiping and hanging out. I meet really nice people at work.

I love my job more than I would have ever imagined possible. It is exciting and filled with kindness. I work with phenomenal people on staff, as volunteers, peer educators and clients. Doing this work has changed my life and I am a better person because of it.

Does that sound cheesy? Oh well.

6. What other services does CNN provide?

We give out:
• Lots of information on Hep c, HIV, particular drugs, safer tips for sex workers, safer injecting techniques, preventing infections, taking care of yourself for trans folks, finding 12 step program meetings, etc.
• Clean needles - for drugs and for hormones or steroids.
• Condoms, dental dams and female condoms (when we can afford this last item!)
• Wound care kits - our folks have a lot of abscesses and many won't see a doc for them
• Safer injecting equipment - cotton balls (for filtering the drugs), cookers (small metal container for heating up and/or mixing drugs), tourniquets (to tie off the arm to make the veins pop out), alcohol wipes (to clean the injection site prior to use), sterile water (to mix the drugs)
• Vitamins and vein care salve. The salve is a herbal vitamin E based salve to use on scars to reduce the thickness of them as they get better.
• ID cards - which have a secret code on them that shows they are part of the needle exchange. These are so that the cops will leave them alone since they are taking part in a city sponsored program. This card doesn't help that much. Hopefully one day it will.
• When people give us stuff we give out food sometimes, clothes - especially warm clothes in the winter and whatever else. Some people's junk can be very valuable to some of the people we meet.

Services:
• Tons of referrals - mostly to drug treatment and health services but also for housing, mental health, legal help etc
• Testing - HIV, Hep C, sexually transmitted infections, TB, etc.
• Primary health care at our clinic downtown - we do everything from pap smears to blood sugar level testing, our nurse practitioner does it all! She even gives out vaccines when we can afford to buy them.
• We buy all our own medicines and have a pharmacist who gives this stuff out for free - do you know how rare that is? It is expensive, so we don't always have the stuff we need, but we have the basics. We always have antibiotics of all sorts, asthma emergency medications etc.
• We have a lawyer that helps us out sometimes. We could use another one.

7. Are the communities in which you work supportive, resistant, or mixed in response to the needle exchange's presence?

Hollywood hates us. The gentrification of Hollywood has caused us to lose our drop in center and has kept us from having stable housing for our program for the past 4 years. We have even been moved from street to street in Hollywood as if working out of a truck weren't sucky enough. Our city council members support us but are often swayed by homeowners and business owner interests.

I guess NIMBYism is really the name of the game with needle exchange. Not In My Backyard.

Pico Union and Skid Row have generally been happy enough to leave us alone. We like this!

8. What's your preferred mode of transportation?

I like trains and subways. This is impractical here so I am developing a love of cars.

I loved this old Volvo that we nicknamed the "Millennium Falcon." It had a sunroof and was so sturdy I could have balanced goblets of champagne on the hood to chill it on the ride home. It was incredibly slow and then one day it just plain stopped. Boo. My beat up Corolla is OK for now.

9. How often do you ride the MTA subway or light rail?

Never any more. I have to drive to work and for work.

10. What's your favorite movie or TV show that's based in LA?

I don't watch that much television. I used to love "LA Law." How skanky is that? I think I was in love with Jimmy Smitts and the downtown LA skyline.

11. Share your best celebrity sighting experience.

Schwarzenegger stared at my and my friend Danielle's asses in my first month here on Rodeo Drive. I guess he was just bored - they were filming a movie. And I shouldn't be flattered given that he does the same thing to 80 year old ladies.

12. What's the best place to walk in LA?

Along the LA River. It is so beautiful in its own way. I don't recommend canoeing it - we did it. The water is so nasty and there's a surprising amount of red worms that crawl into your shorts and socks.

13. It's 9:30 PM on a Thursday. Where are you coming from and where are you going?

I am handing out needles at the corner of Sycamore and Santa Monica Blvd. We finish at 10 or so. Usually around this time of night we have decided to pick on a volunteer - it's just the way the world works. We tend to make a lot of fun of one another to pass the time when it's cold out. Other nights I will be making a burger run for everyone at In N' Out on Sunset.

14. If you could live in LA during any era, when would it be?

I wish I had been here in the late 80s and early 90s to work with some of my artist and AIDS activist heroes. I would have loved to check out the Women's Building downtown and see the performance artists in their hey day.

LA in the late 70s and early 80s would have been amazing, too. I would have been psyched to go to the old punk shows.

15. What is the "center" of LA to you?

The center of LA for me is the corner of Edgemont and Hollywood Blvd. That is the location of my favorite apartment. It is where I learned how to navigate this huge place so it will always be my point of reference on a map or when giving totally convoluted directions to anyone willing to risk them.

16. If you were forced to live in a neighboring county, which would you choose? Ventura County is a wussy answer.

I'm Canadian and I have no sense of geography. In fact I just made an ass of myself in a presentation about LA at the national harm reduction conference in New Orleans by pointing to the OC when I was trying to point to Tarzana.

So I say - Mexico County!

17. If you could live in any neighborhood or specific house in LA, where/which would you choose?

I would live in Echo Park overlooking Elysian Park. I love Echo Park but I can't afford a house there. I am happy in Silver Lake too, but because I am thinking of buying a place I have to set my eyes on Chino or North Hollywood.

18. What is the city's greatest secret?

It is such a secret I don't even know how to find the man again. He was a vendor working in the parking lot of Sanamluang on Sundays. He made these unbelievable spicy coconut pancake-ball-thingys. You could get 15 for $1 and they were sooooo good. I must find this man again.

19. Drinking, driving. They mix poorly, and yet they're inexorably linked. How do you handle this conflict?

I do drugs instead! Just kidding. Or maybe not? Who knows...

Other times I try to drink a bucket of water and wait out the booze. Then I drive home in very slow spurts. I slept in my car behind the Pier One Imports on Hollywood near the 101 entrance when I felt too messed up to get home. Woke up a few hours later, felt good and went home to bed. That was pathetic.

20. Describe your best LA dining experience.

OK - I have a couple.

a) I used to be friends with this amazing pastry chef. We had a big fight over a cat and now we don't talk - go figure. But my best dining experience was taking my parents and boyfriend Ben over to the restaurant she worked at - Opaline - and having her amazing hazelnut cake and berry tart.

b) My first birthday here - approximately 3 weeks into my tenure here. I met lots of nice folks and invited them to a dim sum breakfast birthday at the Empress Pavilion. They came and were super super nice and they are still my friends today.

21. What do you have to say to East Coast supremacists?

I don't know much about them. But they are colder than me.

22. Do you find the threat of earthquakes preferable to the threat of hurricanes and long winters?

Fuck yeah. I grew up in Saskatchewan, Canada. I froze my ear canals riding my bike to school. I will happily get jostled around if I never have to feel - 45C again. Yeow!

23. Where do you want to be when the Big One hits?

At home with Ben and the cats. This melting cottage that I call my home is probably going to be the only building left standing in LA. It has no straight lines anywhere in the structure. It's kind of like a lopsided igloo and may slide down the hill, but after all this time I doubt it will buckle on our heads.

Shoshanna can be contacted at: scholar@cleanneedlesnow.org