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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

Author

Listed:
  • 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)

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.

Suggested Citation

  • Emily Pegler & Gail Garvey & Lisa Fitzgerald & Amanda Kvassay & Nik Alexander & Geoff Davey & Diane Rowling & Andrew Smirnov, 2025. "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," IJERPH, MDPI, vol. 22(7), pages 1-19, July.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1120-:d:1702734
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    References listed on IDEAS

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    1. Phelan, Jo C. & Link, Bruce G. & Dovidio, John F., 2008. "Stigma and prejudice: One animal or two?," Social Science & Medicine, Elsevier, vol. 67(3), pages 358-367, August.
    2. Lisa Jamieson & Xiangqun Ju & Dandara Haag & Pedro Ribeiro & Gustavo Soares & Joanne Hedges, 2023. "An intersectionality approach to Indigenous oral health inequities; the super-additive impacts of racism and negative life events," PLOS ONE, Public Library of Science, vol. 18(1), pages 1-12, January.
    3. Kathomi Gatwiri & Darlene Rotumah & Elizabeth Rix, 2021. "BlackLivesMatter in Healthcare: Racism and Implications for Health Inequity among Aboriginal and Torres Strait Islander Peoples in Australia," IJERPH, MDPI, vol. 18(9), pages 1-11, April.
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