The Unique Experience of Intersectional Stigma and Racism for Aboriginal and Torres Strait Islander People Who Inject Drugs, and Its Effect on Healthcare and Harm Reduction Service Access

Emily Pegler (), Gail Garvey, Lisa Fitzgerald, Amanda Kvassay, Nik Alexander, Geoff Davey, Diane Rowling and Andrew Smirnov
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Emily Pegler: School of Public Health, University of Queensland, Herston, QLD 4006, Australia
Gail Garvey: School of Public Health, University of Queensland, Herston, QLD 4006, Australia
Lisa Fitzgerald: School of Public Health, University of Queensland, Herston, QLD 4006, Australia
Amanda Kvassay: Queensland Injectors Health Network (QuIHN), Bowen Hills, QLD 4006, Australia
Nik Alexander: Queensland Injectors Health Network (QuIHN), Bowen Hills, QLD 4006, Australia
Geoff Davey: Queensland Injectors Health Network (QuIHN), Bowen Hills, QLD 4006, Australia
Diane Rowling: Metro North Sexual Health and HIV Unit Windsor, Brisbane City, QLD 4032, Australia
Andrew Smirnov: School of Public Health, University of Queensland, Herston, QLD 4006, Australia

IJERPH, 2025, vol. 22, issue 7, 1-19

Abstract: Aboriginal and Torres Strait Islander people who inject drugs face persistent health inequities, highlighting the need for programs that meet the needs of these groups. This study explored how intersectional stigma and discrimination affect Aboriginal and Torres Strait Islander people’s access to quality healthcare. Aboriginal and Torres Strait Islander participants aged ≥18 years who had injected drugs within the past 12 months were recruited from two regional needle and syringe programs (NSPs) and a major city NSP in Queensland, Australia. Participants completed a structured survey and yarned with an Aboriginal researcher and non-Indigenous research assistant about their healthcare experiences. Through a process of reflexive and thematic analysis, three major qualitative themes emerged: participants’ social circumstances and mental health challenges made help-seeking difficult and complex; enacted stigma and racism diminished access to health services and the quality of care received; and injecting drug use was associated with disconnection from culture and community. Privileging the expertise and voices of those with lived/living experience is essential for the creation of culturally safe, inclusive, and destigmatising healthcare services for Aboriginal and Torres Strait Islander people who inject drugs.

Keywords: harm reduction; injecting drug use; Indigenous peoples; lived/living experience; stigma; racism; healthcare service access (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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