Christensen Shannon, Richmond Jacqui, Beavon Emma, Gorringe Adrian, Adamson Emily, Wallace Jack, Armstrong Paul, Gobeil John, Morrison Ele, Crawford Sione, Gavin Nadia, Harrod Mary Ellen, Henderson Charles, Pedrana Alisa, Walsh Louisa
Burnet Institute, Melbourne, Australia.
School of Nursing, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Australia.
Harm Reduct J. 2025 Jul 25;22(1):127. doi: 10.1186/s12954-025-01282-0.
Peer workers with lived-living experience of illicit drug use and/or bloodborne viruses are critical in linking community with health services and programs. Despite the increasing demand for, and recognition of, the value and contributions of peer workers, the risk of workplace stigma and discrimination due to their lived-living experience remains a persistent issue. This scoping review aims to map available literature about workplace stigma and discrimination against peer workers with lived-living experience of drug use or bloodborne virus. The methods used in this scoping review were guided by the Joanna Briggs Institute methodology. A Population-Context-Concept format was used to develop search strategies conducted across four databases to assess articles for eligibility. Community representatives from Australian national and state-based peer-led Drug User Organisations provided input and expertise into all components of this review. Data was extracted and analysed from 61 articles that met the inclusion criteria. Findings were mapped against five levels the Socioecological Model of Health framework, and presented as key risk factors that either increase vulnerability to or sustain stigma and discrimination in the workplace, or protective factors that promote resilience and positive workplace experiences for peer workers. This review highlights that workplace stigma and discrimination towards peer workers takes many forms, including increased emotional labour, negative attitudes or behaviours towards peer workers from non-peer staff, disparities in working conditions between peer workers and non-peer staff, and law enforcement activities that impact peer work. Workplace stigma and discrimination experienced by peer workers can be addressed through adequate planning and the development of organisations and systems that address and acknowledge the existence of stigma and work to create safe work environments for peer workers. This includes organisational policies and training which recognises the unique emotional burdens experienced by peer work and addresses unequal employment conditions between peer- and non-peer staff, and broader societal changes around how drug use is policed.
有非法药物使用和/或血源病毒生活经历的同伴工作者对于将社区与卫生服务及项目联系起来至关重要。尽管对同伴工作者的价值和贡献的需求日益增加且得到认可，但由于他们的生活经历，工作场所存在耻辱感和歧视的风险仍然是一个长期问题。本范围综述旨在梳理有关工作场所对有药物使用或血源病毒生活经历的同伴工作者的耻辱感和歧视的现有文献。本范围综述中使用的方法以乔安娜·布里格斯研究所的方法为指导。采用人群-背景-概念格式制定搜索策略，在四个数据库中进行搜索，以评估文章的 eligibility。来自澳大利亚国家和州级同伴主导的吸毒者组织的社区代表为本综述的所有组成部分提供了意见和专业知识。从61篇符合纳入标准的文章中提取并分析了数据。研究结果根据健康社会生态模型框架的五个层次进行梳理，并呈现为增加工作场所耻辱感和歧视的易感性或维持这种情况的关键风险因素，或促进同伴工作者恢复力和积极工作体验的保护因素。本综述强调，工作场所对同伴工作者的耻辱感和歧视有多种形式，包括增加的情感劳动、非同伴工作人员对同伴工作者的负面态度或行为、同伴工作人员与非同伴工作人员之间工作条件的差异以及影响同伴工作的执法活动。同伴工作者所经历的工作场所耻辱感和歧视可以通过充分规划以及建立能够解决和承认耻辱感存在并努力为同伴工作者创造安全工作环境的组织和系统来解决。这包括组织政策和培训，这些政策和培训认识到同伴工作所经历的独特情感负担，并解决同伴与非同伴工作人员之间不平等的就业条件，以及围绕药物使用监管方式的更广泛社会变革。
