Many young people may be struggling to define or re-define family. They may have had struggles or conflicts with their family of origin, grown up in foster care, or never experienced strong family bonds. Definitions of family subsequently become more fluid, with young people forming strong networks among their peers and other people that they feel are loyal, trustworthy, and willing to accept them. In some cases, young people may “test” SAP workers in ways that challenge these values. Transparency, honesty and respect can go a long way. Developing youth-specific services may pose certain legal challenges and require a level of sensitivity even beyond regular SAP services. Child protection laws, mandatory reporting and parental rights issues can come into play with younger users and it is important for SAPs to understand any potential legal restrictions while maintaining the highest level of confidentiality and professionalism. Investigate age-specific guidelines about working with youth, such as intake or counseling requirements. The SAP will also have to decide who is considered “youth”. Programs and services that specifically target youth can face challenges when people age out of eligibility for the program (get too old) or when young peoples’ primary social networks are older and therefore would not be eligible for the same youth-specific services. Finding ways to transition young people to other services provides continuity of care, maintaining and supporting the stability of participants. Unfortunately, younger adults may not yet feel comfortable in programs that serve older adults with different lifestyles or at different stages in their use. Collaborations between youth and adult/multi-age programs can encourage cooperative education and age-appropriate programming. Other strategies for SAPs working with youth: • Develop referral networks for youth-sensitive/specific housing assistance. • Connect youth with health care services that are appropriate for and sensitive to their needs. • Design culturally appropriate outreach and education materials accessible to youth. • Choose hours of operation that are manageable and realistic for youth. • Conduct support groups specific to youth on topics chosen by youth • Emphasize early and consistent HCV and HIV testing to support prevention and identify new infections early. • Make showers and laundry services available. • Consider special services such as access to sterile tattoo and piercing needles. • Emphasize safer sex messages and education, including birth control. • Be creative! • Prioritize confidentiality and safety. • Acknowledge and validate the diversity and individuality of youth.
Sex Wor k e r s Drug use and sex work have a complex relationship. Sex workers face stigma, discrimination, criminalization and violence on many levels and are often among the most marginalized and underserved populations. Engaging in multiple levels of illegal activity, sex workers may be less likely to access services for fear of judgment (from SAP staff or other participants), yet may have an even higher level of need than non-sex working clients. Sex work often entails negotiating relationships with complicated power dynamics that can influence an individual’s level of drugrelated risks while drug use may shape how and to what degree sex workers manage their safety and relationships. SAPs have a responsibility to understand the unique needs of sex workers and take steps to meet these needs with compassion and sensitivity. SAPs should provide training to their staff to help them understand the needs of sex workers, and confront any personal stigma or judgment they may bring with them to the job. Staff should understand that sex work encompasses a range of activities including but not limited to dancing, escort services, stripping and modeling as well as full- and limited-service sex trade. It is not uncommon for drug users to trade sex for drugs. Given the persistent need for money in order to maintain -68-
