Rivera Alexis V, DeCuir Jennifer, Crawford Natalie D, Amesty Silvia, Lewis Crystal Fuller
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA; College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA.
Drug Alcohol Depend. 2014 Nov 1;144:259-64. doi: 10.1016/j.drugalcdep.2014.09.778. Epub 2014 Oct 2.
Little is known on the effect of stigma on the health and behavior of people who inject drugs (PWID). PWID may internalize these negative attitudes and experiences and stigmatize themselves (internalized stigma). With previous research suggesting a harmful effect of internalized stigma on health behaviors, we aimed to determine socio-demographic characteristics and injection risk behaviors associated with internalized PWID-related stigma in New York City (NYC).
Three NYC pharmacies assisted in recruiting PWID. Pharmacy-recruited PWID syringe customers received training in recruiting up to three of their peers. Participants completed a survey on injection behaviors and PWID-related stigma. Among HIV-negative PWID (n=132), multiple linear regression with GEE (to account for peer network clustering) was used to examine associations with internalized PWID-related stigma.
Latinos were more likely to have higher internalized stigma, as were those with lower educational attainment. Those with higher internalized stigma were more likely to not use a syringe exchange program (SEP) recently, although no association was found with the recent use of pharmacies for syringes. Lastly, higher internalized stigma was related to less than 100% use of pharmacies or SEPs for syringe needs.
These data suggest that PWID with higher internalized stigma are less likely to consistently use sterile syringe sources in urban settings with multiple sterile syringe access points. These results support the need for individual- and structural-level interventions that address PWID-related stigma. Future research is needed to examine why PWID with higher internalized stigma have less consistent use of public syringe access venues.
关于污名对注射吸毒者（PWID）健康和行为的影响，人们了解甚少。注射吸毒者可能会将这些负面态度和经历内化，并自我污名化（内化污名）。先前的研究表明内化污名对健康行为有有害影响，我们旨在确定纽约市（NYC）与与注射吸毒者相关的内化污名相关的社会人口特征和注射风险行为。
纽约市的三家药店协助招募注射吸毒者。通过药店招募的注射吸毒者注射器顾客接受了培训，以便最多招募三名同龄人。参与者完成了一项关于注射行为和与注射吸毒者相关污名的调查。在艾滋病毒阴性的注射吸毒者（n = 132）中，使用广义估计方程（GEE）进行多元线性回归（以考虑同伴网络聚类）来检查与与注射吸毒者相关的内化污名的关联。
拉丁裔更有可能有更高的内化污名，受教育程度较低的人也是如此。内化污名较高的人最近更有可能不使用注射器交换计划（SEP），尽管未发现与最近使用药店获取注射器有关联。最后，较高的内化污名与不到100%使用药店或SEP满足注射器需求有关。
这些数据表明，内化污名较高的注射吸毒者在有多个无菌注射器获取点的城市环境中，不太可能持续使用无菌注射器来源。这些结果支持需要在个人和结构层面进行干预，以解决与注射吸毒者相关的污名问题。未来需要进行研究，以检查为什么内化污名较高的注射吸毒者对公共注射器获取场所的使用不太一致。
