title: Negotiating place and gendered violence in Canada's largest open drug scene.
abstract: BACKGROUND
  Vancouver's Downtown Eastside is home to Canada's largest street-based drug scene and only supervised injection facility (Insite). High levels of violence among men and women have been documented in this neighbourhood. This study was undertaken to explore the role of violence in shaping the socio-spatial relations of women and 'marginal men' (i.e., those occupying subordinate positions within the drug scene) in the Downtown Eastside, including access to Insite.
  
  
  METHODS
  Semi-structured qualitative interviews were conducted with 23 people who inject drugs (PWID) recruited through the Vancouver Area Network of Drug Users, a local drug user organization. Interviews included a mapping exercise. Interview transcripts and maps were analyzed thematically, with an emphasis on how gendered violence shaped participants' spatial practices.
  
  
  RESULTS
  Hegemonic forms of masculinity operating within the Downtown Eastside framed the everyday violence experienced by women and marginal men. This violence shaped the spatial practices of women and marginal men, in that they avoided drug scene milieus where they had experienced violence or that they perceived to be dangerous. Some men linked their spatial restrictions to the perceived 'dope quality' of neighbourhood drug dealers to maintain claims to dominant masculinities while enacting spatial strategies to promote safety. Environmental supports provided by health and social care agencies were critical in enabling women and marginal men to negotiate place and survival within the context of drug scene violence. Access to Insite did not motivate participants to enter into "dangerous" drug scene milieus but they did venture into these areas if necessary to obtain drugs or generate income.
  
  
  CONCLUSIONS
  Gendered violence is critical in restricting the geographies of men and marginal men within the street-based drug scene. There is a need to scale up existing environmental interventions, including supervised injection services, to minimize violence and potential drug-related risks among these highly-vulnerable PWID.
authors: BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada. Electronic address: rmcneil@cfenet.ubc.ca.
authors: Ryan
authors: R
authors: McNeil
authors: BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Kate
authors: K
authors: Shannon
authors: Vancouver Area Network of Drug Users, Vancouver, British Columbia, Canada.
authors: Laura
authors: L
authors: Shaver
authors: BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Thomas
authors: T
authors: Kerr
authors: BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
authors: Will
authors: W
authors: Small
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D003625:Data Collection; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D057228:Masculinity; D008875:Middle Aged; D018671:Needle-Exchange Programs; D012737:Sex Factors; D062206:Spatial Analysis; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014754:Violence / Q000706:statistics & numerical data*
keywords: Gender; Injection drug use; Masculinity; Qualitative; Social geography; Supervised injection facilities; Violence