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Expert Q&A

Supporting Health and Safety of Sex Workers and People Who Use Drugs: A Q&A With Project SAFE

Vital Strategies

By Kyli Rodriguez-Cayro

On March 3, sex worker communities and organizations recognize International Sex Workers Rights Day. Since 2001, this important day has celebrated the resilience of sex workers around the world and the advocacy work by those who push for stronger rights and protections for themselves and their peers.

International Sex Workers Rights Day also shines a spotlight on the role of sex workers in the harm reduction movement, the critical need to decriminalize sex work, and the importance of addressing the social and health inequities experienced by people who use drugs and those involved in sex work.

At the Vital Strategies Overdose Prevention Program, we recognize that the fight for sex workers’ rights, and our work to reduce fatal overdose and drug related harms, are inextricably tied and closely aligned with the goals and values of supporting those most affected by the criminalization of drug use. Since 2020 we have supported Project SAFE, a Philadelphia-based mutual aid collective led by people who use drugs and are involved in sex work.

In honor of International Sex Workers Rights Day, Vital Strategies spoke with Aisha Mohammed of Project SAFE about their upcoming “Not Welcome Anywhere” exhibit, and about mobilizing communities to better support sex workers and people who use drugs through health policy reform and harm reduction.

With support from Vital Strategies, Project SAFE has created several educational toolkits, such as “Survival Strategies While Using Drugs Alone, from People Who Use Drugs.” Most recently, Project SAFE released “Imperfect Perfection: Running a Community Engagement Worker Program for People Who Use Drugs and Trade Sex.” This guide outlines the organization’s philosophy for providing peer-led services to people who use drugs and trade sex.

Why are community mobilization and peer-informed resources so important when it comes to supporting the health and wellness of sex workers and people who use drugs?

People who trade sex and use drugs are the most knowledgeable about what they need and what will be most beneficial for them. For instance, when our members were experiencing a horrific spate of violence in 2016, they asked for pepper spray, which has been effective for some to deter assault. Similarly, as the drug supply and drug use patterns change, our members let us know which types of syringes or pipes would be most useful. Our community engagement workers are people who have living expertise with sex work and drug use; they are embedded in communities and peer-based networks of sex workers and drug users. They distribute supplies and information to people who have no interaction with service providers due to stigma, histories of mistrust and other barriers. Community engagement workers are key players in overdose and blood-borne infection prevention, and underscore the importance of peer-led resources. At Project SAFE, we are striving to not only be peer-informed, but peer-led.

What do you hope service providers who work with sex workers and people who use drugs will take away from the Community Engagement Worker Guide?

We hope that they will get some insight into how to shift away from a social work mindset that reinforces a particular power dynamic—one in which the service provider is, in effect, “managing” the community engagement worker instead of developing a collaborative relationship rooted in the worker’s autonomy and deep knowledge. We hope that service providers will take away an understanding of the power of peer networks in helping people survive and care for each other, and see how materially supporting someone to take on the role of a community engagement worker—and doing so in a non-controlling way—enables harm reduction information and supplies to reach people who have little or no contact with service providers.

Can you tell us about your upcoming “Not Welcome Anywhere” exhibit and report?

We are hosting an art exhibit highlighting the findings of a community research study, “Not Welcome Anywhere: Exclusion From and Inaccessibility of Legal, Medical and Social Services for People Who Trade Sex and Use Drugs.The exhibit will feature photographs, visuals, and audio and written narratives by people who use drugs and trade sex in the Kensington neighborhood of Philadelphia. The artwork and narratives detail the struggles and challenges people encounter in their everyday lives; it also depicts the ways in which they address harms created by state policies that criminalize the very activities—such as drug use and sex work—that people engage in to survive the brutality of capitalism.


The exhibit aims to highlight the primary findings of the report, which are that the legal, medical, and social services designed to support people engaging in chaotic substance use are not only inaccessible but inadequate for dealing with the complexities of people’s lives. These same services also fail to recognize that state policies, not individuals, are ultimately accountable for creating the conditions that contribute to chaotic substance use and the overdose crisis.

Over the next couple of years, what policy reforms would you like to see to advance the rights of sex workers and people who use drugs?

We would like to see the full spectrum of sex work and drug use decriminalized in order to destigmatize both these activities and to begin investing in social, medical and legal services designed, created and run by people who use drugs and trade sex. We would like to see the establishment of safe supply sites throughout the U.S. to give people an alternative from the adulterated drug supply and to drastically reduce overdose deaths.

What is one thing you’d want someone new to the harm reduction movement to understand?

One of the most impactful ways to support people trading sex and using drugs is to share resources and provide material support, such as cash assistance and harm reduction supplies.

Additional resources from Project SAFE and Vital Strategies:

With support from Vital Strategies, Project SAFE published the guide Using Drugs Alone. This resource was created by and for people who use drugs, offering strategies and tips to address and reduce the potential harms of using drugs alone. 

Survival Strategies for People Who Use Drugs was developed by Project SAFE in tandem with the Using Drugs Alone guide. In addition to sharing the information from the guide, this toolkit offers suggestions for effective harm reduction and public health messaging about using alone.

To learn more about Project SAFE, visit

About Vital Strategies’ Overdose Prevention Program

Vital’s Overdose Prevention Program works to strengthen and scale evidence-based, data-driven policies and interventions to create equitable and sustainable reductions in overdose deaths. Work across seven U.S. states is supported by funding from the Bloomberg Philanthropies Overdose Prevention Initiative, launched in 2018, and by targeted investments from other partners. Learn more here.