Stigma in Healthcare Settings is Associated With Reduced Healthcare Access Among Women Who Inject Drugs

Few studies focus on the distinct experiences and health outcomes of women who inject drugs. Researchers performed a cross-sectional study analyzing the association between experience of healthcare stigma and healthcare access among women who inject drugs using a subset of Australian survey data collected between October and December 2021 (N=232). “Reduced healthcare access” was defined as the following: delaying care, not disclosing drug use, downplaying the need for pain medication, looking for alternative health services, or not attending follow-up appointments.

• Of the women included in this study, 75 percent injected drugs weekly or more and 40 percent had shared needles in the past month.
• While 20 percent of women reported not experiencing any stigma or discrimination related to drug use in the past year, 90 percent had engaged in at least one strategy to avoid experiencing stigma in a healthcare setting.
• Variables that predicted reduced healthcare access were reduced well-being, negative treatment by a health worker in the past year, higher injecting frequency, being employed, and LGBTQ identity.

Comments: This study provides insight into the consequences of healthcare stigma experienced by women who inject drugs. Lower well-being scores, higher injecting frequency, and LGBTQ identity may negatively impact healthcare access because of higher rates of stigma in these groups. Fear of stigma negatively impacting employment may lead to reduced healthcare access among employed women who inject drugs. We must do more to eliminate policies and behaviors that perpetuate stigma related to drug use in order to provide optimal care to this high-risk group of patients.

Brigid Adviento, MD, MPH* & Darius A. Rastegar, MD

* 2023–24 Rich Saitz Editorial Intern & Addiction Medicine Fellow, University of Iowa Hospitals and Clinics

Reference: Brener L, Cama E, Broady T, et al. Experiences of stigma and subsequent reduced access to health care among women who inject drugs. Drug Alcohol Rev. 2024 [Epub ahead of print]. doi:10.1111/dar.13806