Theme: Social Science & Policy Research Year: 2024
Background: Persons who use drugs (PWUD) face stigma and discrimination in their daily lives, including in health settings. These experiences affect their choices towards harm reduction care. The use of Information, communication and technology (ICT) in health care through digital platforms of health information and care delivery has flourished. Knowledge around whether such ICT contribute towards experiences of stigma is sparse. This study aims to understand how acts of stigma influence access to for PWUD, with a focus on the role of information and technology.
Approach: The study builds on Goffman’s concept of stigma and notion of spoiled identity, in the field of harm reduction and information systems research. A qualitative methodology was undertaken: 14 interviews and 3 focus group discussions were held with PWUD, harm reduction staff, managers and consultants. Cultural probing was used to observe participant experiences with an information mobile app. Field notes and informal discussions were included in an interpretive thematic analysis. Ethical considerations were made.
Analysis: ICT used to enhance health care access create barriers by augmenting experiences of stigma for PWUD. Social media platforms and mobile apps designed to engage and share health information, leave them feeling stigmatised even before they access care. The fear of being traumatised by the digital interaction and identified as diseased and spoiled, heightens obstacles for PWUD seeking care.
Conclusion: The study identifies socio-technical aspects of care where existing challenges due to societal stigma are mirrored in the ICT that surround PWUD. A perpetual digital spoiled identity is created with continued stigmatisation through interactions with the digital. Health practitioners may use findings beneficial to realise the need to involve persons with lived experiences in the design of digital tools for health. Policy-makers may employ results to enhance protection of the marginalised.
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