TY - JOUR

T1 - “Who has ever loved a drug addict? It’s a lie. They think a ‘teja’ is as bad person”

T2 - multiple stigmas faced by women who inject drugs in coastal Kenya

AU - Mburu, Gitau

AU - Ayon, Sylvia

AU - Tsai, Alexander C.

AU - Ndimbii, James

AU - Wang, Bangyuan

AU - Strathdee, Steffanie

AU - Seeley , Janet

PY - 2018/5/25

Y1 - 2018/5/25

N2 - BackgroundA tenth of all people who inject drugs in Kenya are women, yet their social contexts and experiences remain poorly understood. This paper reports how multiple forms of stigma are experienced by women who inject drugs in coastal Kenya and the impact that they have on their ability to access essential health services.MethodsIn 2015, in-depth interviews and focus group discussions were held with 45 women who inject drugs in two coastal towns. These data were supplemented with in-depth interviews with five individual stakeholders involved in service provision to this population. Data were analyzed thematically using NVivo.ResultsWomen who inject drugs experience multiple stigmas, often simultaneously. These included the external stigma and self-stigma of injection drug use, external gender-related stigma of being a female injecting drug user, and the external stigma of being HIV positive (i.e., among those living with HIV). Stigma led to rejection, social exclusion, low self-esteem, and delay or denial of services at health facilities.ConclusionHIV and harm reduction programs should incorporate interventions that address different forms of stigma among women who inject drugs in coastal Kenya. Addressing stigma will require a combination of individual, social, and structural interventions, such as collective empowerment of injecting drug users, training of healthcare providers on issues and needs of women who inject drugs, peer accompaniment to health facilities, addressing wider social determinants of stigma and discrimination, and expansion of harm reduction interventions to change perceptions of communities towards women who inject drugs.

AB - BackgroundA tenth of all people who inject drugs in Kenya are women, yet their social contexts and experiences remain poorly understood. This paper reports how multiple forms of stigma are experienced by women who inject drugs in coastal Kenya and the impact that they have on their ability to access essential health services.MethodsIn 2015, in-depth interviews and focus group discussions were held with 45 women who inject drugs in two coastal towns. These data were supplemented with in-depth interviews with five individual stakeholders involved in service provision to this population. Data were analyzed thematically using NVivo.ResultsWomen who inject drugs experience multiple stigmas, often simultaneously. These included the external stigma and self-stigma of injection drug use, external gender-related stigma of being a female injecting drug user, and the external stigma of being HIV positive (i.e., among those living with HIV). Stigma led to rejection, social exclusion, low self-esteem, and delay or denial of services at health facilities.ConclusionHIV and harm reduction programs should incorporate interventions that address different forms of stigma among women who inject drugs in coastal Kenya. Addressing stigma will require a combination of individual, social, and structural interventions, such as collective empowerment of injecting drug users, training of healthcare providers on issues and needs of women who inject drugs, peer accompaniment to health facilities, addressing wider social determinants of stigma and discrimination, and expansion of harm reduction interventions to change perceptions of communities towards women who inject drugs.

KW - Stigma

KW - HIV

KW - Harm reduction

KW - Injecting drug use

KW - Women who inject drugs

KW - Kenya

U2 - 10.1186/s12954-018-0235-9

DO - 10.1186/s12954-018-0235-9

M3 - Journal article

VL - 15

JO - Harm Reduction Journal

JF - Harm Reduction Journal

SN - 1477-7517

M1 - 29

ER -