Harnessing Harm: ACT UP's Needle Exchange

Recent scholarship in the history of LGBT social movements has highlighted the emergence of a rights-based approach to sexual minoritization crafted in opposition to those marked, in particular, as mentally ill and criminal.  The history of the left in general has demonstrated the systematic exclusion of those seemingly intractable subjects whose choices refuse imperatives to health or engage criminalized economies.  At the same time, queer theory has rejected identity-based frameworks to consider how concepts of health, rationality, and responsibility determine the outsides of normative heterosexuality, but it has not provided an historical, social movement-centered account of these negotiations.  This paper opens with a brief overview to argue for a queer history of how the “addict,” “criminal,” and “lumpenproletariat,” have been produced by, incorporated within, or excluded from a variety of 20^th century U.S. social movements. 

The paper then focuses on the AIDS activist group ACT UP’s advocacy of the “harm reduction” strategy of needle exchange in the 1980s and 1990s.  Needle exchange practices allow for injection drug users to acquire clean needles without the fear of disapprobation or discipline and is seen as a way to reduce rates of HIV infection without stigmatization or criminalization.  It was informally begun among activists during the 1970s and was formalized in later decades even as it remained regulated and/or illegal. ACT UP-New York began underground needle exchange around 1990 and it was cast not only as a way to provide direct services to those most devastated by HIV/AIDS, but also to create affinities between newly politicized actors.  This paper outlines the history of ACT UP’s needle exchange, and asks how it engaged low-income and long-term drug users, in particular, highlighting the dynamics between social service and movement, the categorization of vulnerable populations, and the influence of the practice in shaping the organization’s trajectory.