Factors associated with experiencing stigma, discrimination, and negative health care treatment among people who inject drugs

• Published in: The International journal of drug policy Vol. 128; p. 104468
• Main Authors: Broady, Timothy R., Valerio, Heather, Alavi, Maryam, Wheeler, Alice, Silk, David, Martinello, Marianne, Conway, Anna, Milat, Andrew, Dunlop, Adrian, Murray, Carolyn, Henderson, Charles, Amin, Janaki, Read, Phillip, Marks, Philippa, Degenhardt, Louisa, Stevens, Annabelle, Prain, Bianca, Hayllar, Jeremy, Reid, David, Montebello, Mark, Wade, Alexandra, Christmass, Michael, Cock, Victoria, Dore, Gregory J., Treloar, Carla, Grebely, Jason
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2024
• Subjects: Adult; Australia; Cohort Studies; Cross-Sectional Studies; Discrimination; Female; Hepatitis C; Humans; Ill-Housed Persons; Male; Middle Aged; Needle-Exchange Programs; People who inject drugs; Social Stigma; Stigma; Substance Abuse, Intravenous; Surveys and Questionnaires; Young Adult; Australia; People who inject drugs; Discrimination; Hepatitis C; Stigma
• ISSN: 0955-3959; 1873-4758; 1873-4758
• DOI: 10.1016/j.drugpo.2024.104468

•More than half of people who inject drugs in this cohort study reported experiencing stigma.•Experiences of stigma were less common than in broader community samples of people who inject drugs.•Stigma related to injecting drug use was more common than stigma related to hepatitis C.•Factors associated with different indicators of stigma can inform interventions to reduce stigma. Stigma has negative consequences for the health of people who inject drugs and people living with hepatitis C virus (HCV). This study evaluated factors associated with stigma related to injecting drug use (IDU) or HCV and those associated with being treated negatively by health workers. ETHOS Engage is an observational cohort study of people who inject drugs attending drug treatment clinics and needle and syringe programs in Australia. Participants completed a questionnaire including IDU- and HCV-related stigma, and negative treatment by health workers. Logistic regression was used to identify factors associated with experiencing stigma and negative treatment in a cross-sectional sample. Of 1,211 participants, 31% were women, 64% had injected drugs in the previous month, and 65% had been diagnosed with HCV. IDU-related stigma was reported by 57% of participants and was associated with being a woman, higher than Year 10 education, homelessness, opioid agonist treatment, recent injecting, overdose history, hospitalisation for drug use, and unknown HCV status. HCV-related stigma was reported by 34% of participants diagnosed with HCV and was associated with being a woman, homelessness, receptive needle/syringe sharing, arrest for drug use/possession, and recent HCV testing. Negative treatment from health workers was reported by 45% of participants and was associated with being a woman, receptive needle/syringe sharing, hospitalisation for drug use, and arrest for drug use/possession. Results highlight important intersections and disparities in stigmatising experiences among people who inject drugs. Considering these intersections can assist health services provide more inclusive care.