People Who Inject Drugs Delay Seeking Help to Avoid Stigma

People who inject drugs (PWID) often experience stigma from health care professionals. This negatively impacts the care they receive and may influence their approach to seeking help. Researchers used content from interviews conducted as part of a study on the acceptability of various HIV prevention efforts among PWID in the Northeast US to investigate how stigma impacts PWID healthcare utilization.

• Of the 33 PWID interviewed, most (88%) reported experiencing stigma. Three related themes emerged from the interviews: 1) previous experience with stigma in health care settings; 2) internalizing and resisting stigma; 3) strategies to avoid stigma.
• Participants reported that stigma and assumptions about “med-seeking” led to lower quality of care and rushed encounters.
• Many participants reported feeling shame and embarrassment about their substance use, while others described resistance or indifference to stigma.
• Reported strategies to deal with stigma included: 1) delaying healthcare; 2) not disclosing substance use; 3) downplaying need for pain medication; and 4) seeking alternative services.

Comments: This study provides some insight into the perspective of PWID and the ways in which stigma affects their approach to healthcare and leads to harm. These results reinforce the need for further efforts to reduce stigma in PWID in healthcare settings.

Darius A. Rastegar, MD

Reference: Biancarelli DL, Biello KB, Childs E, et al. Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug Alcohol Depend. 2019;198:80–86.