Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Qual Health Res. 2023 Jul;33(8-9):688-700. doi: 10.1177/10497323231173788. Epub 2023 May 23.
Gay and bisexual men (GBM) report higher rates of sexualised and injecting drug use (IDU) than heterosexual men. Injecting-related stigma is linked to negative health outcomes among people who inject drugs (PWID). This paper describes the ways in which stigmatisation manifests in the narratives of GBM who inject drugs. We conducted in-depth interviews with Australian GBM with IDU histories, exploring drug use, pleasure, risk, and relationality. Data were analysed using discourse analytical approaches. Interviewees (n = 19), aged 24-60 years, narrated their experiences of IDU practice over 2-32 years. Most (n = 18) injected methamphetamine, and used other (non-injected) drugs, in sexual contexts. From participants' narratives, we developed two themes related to stigmatisation of PWID that illustrate the limitations of conventional drug discourses to narrate GBM's experiences. The first theme captures participants' attempts to , outlining the layering of stigma faced by GBM who inject drugs. Linguistically, participants transformed injecting stigma by distinguishing their personal practice from that of more discreditable drug users. Practically, they mitigated stigmatisation by keeping discrediting information from others. The second theme illustrates how by , participants took up prominent discursive practices linking IDU with trauma and pathology. Participants exerted agency by broadening available interpretive repertoires for understanding IDU among GBM, thus creating a counter-discourse. We argue that mainstream discursive practices reverberate through gay communities, perpetuating stigmatisation of PWID and inhibiting care-seeking. More narration of unconventional experiences, beyond insular social groups and critical scholarship, is needed in public discourse to effect destigmatisation.
男同性恋和双性恋者（GBM）比异性恋男性报告更高的性行为和注射毒品使用率（IDU）。与注射毒品相关的污名与注射毒品者（PWID）的负面健康结果有关。本文描述了在注射毒品的 GBM 的叙述中污名化表现的方式。我们对有 IDU 病史的澳大利亚 GBM 进行了深入访谈，探讨了他们的毒品使用、快乐、风险和关系。使用话语分析方法对数据进行了分析。受访者（n=19）年龄在 24-60 岁之间，讲述了他们 2-32 年的 IDU 经历。大多数（n=18）注射冰毒，并在性环境中使用其他（非注射）药物。从参与者的叙述中，我们开发了两个与 PWID 污名化相关的主题，这些主题说明了传统毒品话语在叙述 GBM 经历方面的局限性。第一个主题捕捉到了参与者的努力，描绘了注射毒品的 GBM 面临的污名化的分层。从语言上讲，参与者通过将自己的个人实践与更不受欢迎的吸毒者区分开来，来改变注射污名化。实际上，他们通过不让其他人知道诋毁性信息来减轻污名化。第二个主题说明了通过，参与者采用了将 IDU 与创伤和病理学联系起来的突出话语实践。参与者通过拓宽理解 GBM 中的 IDU 的可用解释性资源来发挥能动性，从而创造了一种反话语。我们认为，主流话语实践在同性恋社区中回荡，使 PWID 的污名化持续存在，并阻碍了寻求护理。在公共话语中，需要更多地讲述非传统经验，超越孤立的社会群体和批判性学术，以实现去污名化。
