Rachel Schreiber: Naomi, you have been a sex workers’ rights activist for a long time, and for many years you were the executive director of the St. James Infirmary. I’d like to begin by to asking you about the term harm reduction and how it came to be a guiding methodology of care for sex workers.

Naomi Akers: I first heard about harm reduction at Promise, in the mid-nineties. I had always been interested in drug policy as well, and I’ve always felt that drugs should be legalized and that criminalization is bullshit.

During the 1990s, I was an undergraduate student at San Francisco State University. The executive director of Casa de las Madres, a shelter for women experiencing domestic violence, spoke to our class. I connected very strongly with their mission. I began to volunteer there, and I learned about two significant issues. One, drug users were...

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