Food as Harm Reduction

Food as Harm Reduction

The Food as Harm Reduction (FaHR) study explores the role food provision plays in reducing the harms associated with illicit drug use.  Specific goals of the project are: to determine how and when access to food (or lack thereof) impacts the health and well-being of People Living with HIV/AIDS (PLWHA) who use drugs (PWUD); document how PLWHA who use drugs navigate their environment in order to access food and harm reduction resources; and highlight the importance of safe and supportive food sites as a means of reducing the nutritional harms of drug use.


Study Methodology

Study methodology included a survey of 60 PLWHA who also use illicit drugs (30 Dr. Peter Center participants, 30 non-participants) and mapping combined with qualitative interviews.  The survey found that 88% of respondents experienced some level of food insecurity.  One contributing factor is drug use.  70% said that in the past 12 months, they did not eat enough because of drug use.  Additionally, 77% of all respondents said drug use did affect their diet, including what they ate (64%), how well they ate (62%), when they ate (60%) and where they ate (40%).  All respondents used some form of food assistance, either a food bank program (91%), and/or a free or low-cost meal program (81%) and/or a community kitchen program (30%).  The most commonly used programs were the Dr. Peter Centre, the Positive Outlook Program and the AIDS Vancouver food bank.

Qualitative mapping interviews (10 Dr. Peter Centre participants and 10 non-Dr. Peter Centre participants) which included mapping participants’ most common daily routes through the city indicated that participants did feel that drug use affected their diet.  However, food resources, such as the Dr. Peter Centre, the Positive Outlook Program (POP) at Native Health and the food bank at AIDS Vancouver were critical sites for accessing nutrition and other needed services.  In particular, the Dr. Peter Centre and POP were anchors in participant’s daily routines, often being utilized for breakfast and lunch.  Continued support for these and other programs serving PLWHA who use drugs are critical for maintaining their health and well-being.


Research Team:

Rosalind Baltzer Turje (Dr. Peter Centre, Co-Principal Investigator); Dr. Eugene McCann (Simon Fraser University, Dept. of Geography, Co-Principal Investigator); Patrick McDougall (Dr. Peter Centre); Dr. Christiana Miewald (Simon Fraser University, Dept. of Geography); Dr. Cristina Temenos (University of Manchester, formerly SFU Geography); Grace Dalgarno (Dr. Peter Centre); Rani Wangsawidjaya (Dr. Peter Centre); Alison McIntosh (University of Calgary, formerly SFU Geography); Sean Grieve (Dr. Peter Centre Peer Researcher); Bill Granger (Dr. Peter Centre Peer Researcher); & Megan Woodward (Dr. Peter Centre Peer Researcher).

This study was funded by the Vancouver Foundation and the Social Sciences and Humanities Research Council of Canada.



Miewald, C., McCann, E., Temenos, C., & McIntosh, A. (2019). “I do my best to eat while I’m using”: Mapping the foodscapes of people living with HIV/AIDS who use drugs. Social Science & Medicine, 226, 96-103. 

Miewald, C., McCann, E., McIntosh, A., & Temenos, C. (2018). Food as harm reduction: barriers, strategies, and opportunities at the intersection of nutrition and drug-related harm. Critical Public Health, 28(5), 586-595.

Miewald, C., Grieve, S., McIntosh, A., McCann, E., Temenos, C., & Woodward, M. (2017). Toward inclusion: Researching Food as Harm Reduction in an Urban Foodscape. In Klodawsky, F., Andrew, C., & Siltanen, J. (eds.)  Toward Equity and Inclusion in Canadian Cities: Lessons from Critical Praxis-Oriented Research, McGill-Queen’s University Press, 159-179.

Miewald, C. & McCann, E. (2017).  How drug use affects the diet of people living withAIDS: Summary of Results from the Food As Harm Reduction Study. Right to Food Zine, Fall. Vancouver BC: Downtown Eastside Neighbourhood House, 6-7.



The FaHR community-based research project was recently featured in Filter magazine. 
The FaHR community-based research project was recently featured in an editorial in the Georgia Straight.