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Safer snorting

Make sure to take good care of your nose when you’re snorting. Snorting can irritate the soft tissues inside your nose, and cause sores and tears. Rinsing your nose before and after snorting with a bit of water or saline can help keep your nasal passages moist, and move the substance through your nose.

Sharing straws for snorting can put you at risk for HIV and Hepatitis C. To make snorting safer, use your own straws and mark them so you know which ones belong to you. Some people like to mark their equipment with a string, an elastic band, lipstick or markers.

It’s important to know that these practices can help reduce your risk of HIV and/or Hepatitis C, but they will not eliminate the risk entirely.

The Hep C Handbook: Hep C, safer drug use, tattooing and piercing: http://librarypdf.catie.ca/ATI-70000s/70224.pdf

Safer Snorting: http://librarypdf.catie.ca/ATI-70000s/70220.pdf

Safer Swallowing: http://ohrn.org/wp-content/uploads/2021/06/Connecting_Section3_Safer-Snorting-Swallowing_Pg78-81.pdf

Safer smoking

Take good care of your lips when smoking with a pipe. Smoking drugs can dry out your lips and cause them to crack or burn, which can provide an easy entry for someone else’s blood to get into your body, putting you at risk for HIV and Hepatitis C. To be safer while smoking, have your own pipe and don’t share with others. Some people like to mark their equipment with a string, an elastic band, lipstick or markers so they know what one is theirs.

 If you have to share, try to get your own mouthpiece. Use lip balm or Vaseline on your lips before and while smoking to keep them from cracking and burning. Make sure to let the pipe to cool before using it again to avoid burning yourself.

Talk to your local needle exchange or AIDS Service Organization about a safer smoking or crack kit. They may be able to help you with some new pipes, screens or mouthpieces.

It’s important to know that these practices can help reduce your risk of HIV and/or Hepatitis C, but they will not eliminate the risk entirely.

Safer Crack Smoking: http://librarypdf.catie.ca/ATI-70000s/70216.pdf

Safer Crystal Meth Smoking: http://librarypdf.catie.ca/ATI-70000s/70218.pdf

Safer injecting

Injecting into your vein (intravenous injection) is the most direct way to get drugs into your system, but it also comes with the most health risks. Higher rates of HIV and Hep C transmissions, as well as damage to your veins is often seen in those that inject substances. People who inject substances can get abcesses, cellulitis, phlebitis (inflammation of the vein) and endocarditis (inflammation of the heart membrane). Those things can lead to further complications.

Here are some tips to avoid these infections, and to keep your veins intact:

1) Always use a new needle, never share used needles, or clean and re-use needles! The needle needs to be sharp and new as it is easier on your veins and helps prevent the spread of infections. The entire contents of the cooker, the filter, vial of water, tourniquet and the needle should be thrown out after use in a designated sharps container. Injection supplies and disposal can be found at your closest community needle exchange or harm reduction centre (Mainline Needle Exchange or Direction 180, in Halifax, N.S.). 

There is also the Peer N Peer program  at the AIDS Coalition of Nova Scotia. To fill out an order form, click here.

2) Use your own gear, don't share with others, and follow steps for safer injecting to lower your chance of damaging your veins and getting bacterial infections or viruses that are passed through the blood, like Hepatitis B, C, and HIV. See a safer injecting guide here.

3) Reduce the chance of a fatal overdose by not using alone. Carry naloxone (opioid antidote) and known how to use it and let others know you have it. If you are alone, you can call The National Overdose Response Service (NORS), which is a convenient and confidential 24/7 virtual safe consumption hotline, available anywhere in Canada - 1-888-688-6677.

4) Start low, go slow. Use a small test dose first. Know the source of your drugs and inject yourself. Control of your own use by learning to inject yourself safely.

5) Alternate from one arm to the other to change veins. Your arms are the safest places to inject. However, if you have to inject into other sites like your feet, hands, breast, groin, or your neck, take extra caution with these sites. There are arteries there that increase the risk of bleeding out, or smaller veins that are more likely to burst or become shallow and unusable.

6) Use a double filtration system if you are injecting drugs that come in a pill format. This can help you avoid injecting larger chunks of the substance into your veins.

7) Use an intramuscular injection needle to inject intramuscular substances (hormones, ketamine, naloxone). The needles are bigger than a usual intravenous needle. Instructions for intramuscular injections can be found here:

For local resources about safer injecting you can call:
Mainline Needle Exchange in Halifax (902) 423-9991
Northern Healthy Connections Society in Truro (902) 895-0931
Sharp Advice Needle Exchange in Cape Breton (902) 539-5556.

If you live in the HRM you can also reach out to North End Community Health Centre at https://nechc.com/

Choosing a safer injection site: http://librarypdf.catie.ca/pdf/ATI-70000s/70162.pdf

Sharp Shooters: http://librarypdf.catie.ca/ATI-70000s/70222.pdf

HIV and Drug Injection: http://librarypdf.catie.ca/ATI-70000s/70212.pdf

Dope Guide: http://librarypdf.catie.ca/ATI-30000s/30100.pdf

Also look at these resources regarding signs of opioid and stimulant overdose:

Responding to an opioid overdose: http://librarypdf.catie.ca/ATI-70000s/70214.pdf

Nova Scotia Take-Home Naloxone: http://www.nsnaloxone.com/

How To Save A Life: http://www.nsnaloxone.com/uploads/1/1/2/0/112043611/5-steps_10769038.pdf

HIV- What is HIV?

HIV is a virus that weakens your immune system (your body’s built-in defence against illness). Many times, people do not notice any symptoms or feel ill, so it is possible to live with HIV for many years without knowing. Although you might not know that you are HIV+, you are still able to pass the virus on to others.

Although there is no cure for HIV, there are many treatments that can help keep your immune system strong and help you live a happy and healthy life. Getting tested for HIV is the only way to know if you have the virus for sure.Check out our section on Testing for more information.

If you find out you are HIV+, you can talk with your doctor about when starting treatment may be right for you. HIV is a manageable illness with treatment, and many people with HIV live full lives that include loved ones, families, and have safe and pleasurable sex lives!

Without HIV treatment, your immune system can become compromised and you may not be able to fight off other serious illnesses (such as pneumonia). If your body is weakened to this state, you may receive what is known as an AIDS diagnoses from your doctor.Today, with new treatments and early detection, an AIDS diagnosis is rare.

How is HIV passed from one person to another?

Only five body fluids can contain enough HIV to pass on the virus:

• blood
• semen (including pre-cum)
• rectal fluid
• vaginal fluid
• breast milk

HIV cannot pass through healthy, unbroken skin. The only way it can be transmitted is when one of those five bodily fluids from someone who has HIV enters into the bloodstream of another person. The main entry points are broken skin (sores, cuts, tears, punctures, etc), or the soft, wet linings of the body such as the tip of the penis or foreskin, the vagina, rectum, nose and mouth.

The two main ways HIV can be passed between you and someone else are:

• Through anal or vaginal sex without using a condom
• By sharing needles or other equipment to use drugs (including cookers, pipes, snorting tools)
• Safer Sex tips and tricks

Practicing safer sex can help reduce your risk of getting HIV and other STIs. If you are HIV+, or if you have an STI, practicing safer sex can help reduce the chance of your partner getting HIV or an STI.As with all activities in life, there is some risk involved when we have sex. Practicing safer sex helps us to reduce those risks, while still having pleasurable sexual experiences.

Here are some quick tips to help you practice safer sex…

• Correctly use a latex or polyurethane condom every time you have vaginal or anal sex
• Use a condom or dental dam every time you have oral sex. You can get flavoured dams or condoms that can be fun to try!
• If you can’t find or purchase a dental dam, plastic wrap is a alternative, although not proven it’s a good option for risk reduction. Make sure it is the non-microwavable kind and only use the same piece once before you throw it away.You can always use two pieces together.
• Use water-based or silicone-based lubricants with your condoms and dams. Oil-based lubricants can make latex weaken and break.
• Remember that many lipsticks and lip balm (like Chapstick) contain ingredients that can break down condoms, etc.
• If you are unable to use a condom, make sure to use plenty of lubricant. Keeping your genitals wet and slippery reduces the changes of tears and is more enjoyable for all involved.
• Avoid sharing sex toys, and if you do, cover each one with a new condom before each use. It is also important to clean your toys between vaginal and anal use.
• Get tested for STIs regularly. Having an STI increases your risk of getting and passing on HIV.
• Choose forms of sexual stimulation that pose little or no risk for HIV and other sexually transmitted infections, like masturbation or sensual massage.

Sometimes condoms or dams don’t fit properly. Bodies come in all shapes and sizes, and therefore our protection should, too.Be innovative and find what works for you. For example, latex or polyurethane gloves can be used to create custom barriers:

1. Cut a rubber glove from the wrist band up the side to the top of the pinky finger

2. Now turn the glove side ways and cut underneath the fingers. Do not cut underneath the thumb, only cut until you have cut all four fingers off the glove.

3. You should now be able to unfold the glove and still have the thumb intact; it will look like a square of latex with a sizable compartment.

Sexually Transmitted Infections

Practicing safer sex can help us reduce our risk of sexually transmitted infections too. It’s important to know that not all sexually transmitted infections are passed the same way, and using a condom may not protect you from all of them. 
You may not know if you have an STI. Many STIs have little or no noticeable symptoms, and the only way to be sure is to get tested. Once you know for sure, you can get treatment and/or you can make decisions about your safer sex practices for the future. We know that having an STI can increase your average risk of getting or giving HIV by up to five times. Getting screened for STIs is another great way to ensure the prevention of HIV.

Although it can be scary to be diagnosed with an STI, many STIs are treatable or curable, and you can continue to have a happy and healthy sexual life.

Chlamydia

What is it?
Chlamydia is the most common bacterial STI, and is very common in people between the ages of 15 and 24 years old. Chlamydia can affect the genitals, the rectum, the throat and the eyes. Most people who have chlamydia will have no noticeable symptoms illness; getting screened for chlamydia is the only way to know if you have the illness. In Canada, about twice the number of reported cases were found in women than men, however, people of all genders and ages can get the chlamydia.

Chlamydia can be screened through a urine test or a swab test, and can be cured with antibiotics.

How would I get it?
Chlamydia can be passed between partners through condom-less or barrier-less oral, vaginal, or anal sex. Chlamydia can also be passed from a mother to infant during birth, which may lead to lung and/or eye infections in the infant.

How do I protect myself and my partner?
The best way to protect yourself and your partner from Chlamydia is by using condoms or barriers when having vaginal, anal or oral sex. For other safer sex options, click here.

Gonorrhea

What is it?
Similar to Chlamydia, Gonorrhea is one of the most common bacterial STIs. It can affect the genitals, rectum, throat and eyes and many people have no visible symptoms of the illness. Getting screened for gonorrhea is the only way to tell if you have the infection. Gonorrhea is very common among people between the ages of 15 and 29, and about two-thirds of all cases reported in Canada are in men. This may be that men may have more visible symptoms than women; however persons of all genders and ages can get gonorrhea.

Gonorrhea can be detected through a urine test or a swab test, and can be cured with a dose of antibiotics. Often people being treated for chlamydia will be tested and treated for gonorrhea as well.

How would I get it?
Gonorrhea can be passed between partners through condom-less or barrier-less (no dental dam) oral, vaginal, or anal sex with a partner. Gonorrhea can also be passed from a mother to infant during birth, which may lead to an eye infection in the infant.

How do I protect myself and my partner?
The best way to protect both yourself and your partner from gonorrhea is to use condoms or barriers when having vaginal, anal or oral sex. For other safer sex options, click here.

HPV (Human Papillomavirus)

What is it?
There are over 100 strains of HPV. About 40% of HPV strains are transmitted sexually. Some of these strains can cause anal and genital warts, some can lead to cancer (e.g., cervical, penile, anal or throat cancer) and others have no known effect. There is no cure for HPV, but those people who have anal and genital warts can receive treatment to eliminate visible warts. Once the warts are treated, it is important to know that you still have HPV, and therefore, the warts may reappear in the future.

How would I get it?
HPV is passed through skin-to-skin contact, such as condom-less or barrier-less (no dental dam) vaginal, anal and oral sex. Using condoms or a barriers can help reduce your risk, but not eliminate risk entirely, as the condom or barrier only protects the area it covers.HPV can live on the skin surrounding the groin area, including the upper thighs, and condoms or barriers do not offer protection in these areas.

How do i protect myself and my partner?
The best way to protect yourself and your partner from HPV is to use condoms or barriers when having vaginal, anal and oral sex.For other safer sex options, click here. (link?)

There is a vaccine for certain stains of HPV. Ask your family doctor or a health care provider if the HVP vaccine may be right for you.

Syphilis

What is it?
Syphilis is a bacterial STI that used to be considered rare in Canada, but is now on the rise. Early on in the infection progression, some people may notice painless sores and rashes, but many people do not notice these symptoms.The symptoms may go away on their own, making it hard for someone to know they are infected. After years with no symptoms, syphilis can progress to a serious stage where it can cause damage to the major organs of the body, and can lead to death.

Syphilis can be screened through a blood test, and if caught early, can be cured by antibiotics.

How would I get it?
Syphilis can be passed between partnersthrough condomless or barrierless oral, vaginal, or anal sex by coming in direct contact with bacteria contained in the syphilitic sores or rashes. While using a condom or barrier can reduce your risk, it doesn’t eliminate your risk. Although condoms and barriers are great at reducing exposure to bodily fluids, they only cover a small area of your skin, and Syphilis can be passed though skin to skin contact. Syphilis can also be passed from a woman to a fetus during pregnancy.

How do i protect myself and my partner?
The best way to protect yourself and your partner from syphilis is to use condoms or barriers when having vaginal, anal and oral sex.For other safer sex options, click here.

For more information on HIV and STI prevention and treatment, talk with your local sexual health clinic, family doctor, or medical health professional. The following resources can provide you with some more specific information when making decisions that are the best for you around safer sex and HIV/STI prevention