title: Merchants, samaritans, and public health workers: Secondary syringe exchanger discursive practices.
abstract: Secondary syringe exchangers (SSEs) are a vital component of harm reduction efforts among persons who inject drugs (PWIDs). However, little research has explored how secondary exchange occurs, nor why SSEs do their work. This study looks at secondary exchange as an act of resilience within the PWID risk environment. It asks how secondary syringe exchangers utilize syringes to improve their mental and material well-being.
  
  
  
  This article draws on findings from semi-structured in-depth interviews of 30 SSEs. It is also informed by 4 years of participant observation as a volunteer and site supervisor at the San Francisco Aids Foundation syringe exchange sites, and 1 year of participant observation with SSEs and their clients.
  
  
  
  This study finds that SSEs use syringes as a resource to support three discursive practices - those of merchants, public health workers, and samaritans. These discursive practices correlate to their work and educational backgrounds, and to their accounts of charging for syringes, disseminating public health information, and helping their clients in various ways.
  
  
  
  SSEs hold heterogeneous motivations and operate in multiple contexts. Many SSEs see themselves as, and behave as, informal health care workers or helpers in their community. They could be utilized, with minimal training and encouragement, to disseminate additional harm reduction information and materials.
authors.affiliation: Department of Sociology, Yale University, 493 College Street, New Haven, CT 06511, United States. Electronic address: sarah.brothers@yale.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Brothers
mesh_terms: D000328:Adult; D000368:Aged; D003132:Commerce / Q000191:economics*; D055030:Drug Users / Q000523:psychology; D005260:Female; D040261:Harm Reduction; D006282:Health Personnel / Q000191:economics* / Q000523:psychology; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000191:economics*; D011634:Public Health / Q000191:economics*; D055500:Resilience, Psychological; D012495:San Francisco; D015819:Substance Abuse, Intravenous / Q000191:economics* / Q000523:psychology; D055815:Young Adult
keywords: Harm reduction; In-depth interviews; Injection drug use; Secondary exchange