Stigma is known to negatively affect the health outcomes of people affected by blood-borne viruses (BBVs) and sexually transmissible infections (STIs). Healthcare settings have been identified as key site to encounter stigma. This research builds on more than two decades of research within communities affected by BBVs and STIs and will work in coalition with community and health agencies to develop, trial and evaluate a new type of stigma reduction approach for healthcare services.

This research will include interviews with key informants and healthcare workers about their perceptions of quality healthcare, stigma, and stigma reduction in relation to BBVs and STIs. The research team will conduct 50 in-depth, semi-structured qualitative interviews exploring: (1) understandings of the impact of stigma within healthcare settings; (2) priority areas for intervention; and (3) key opportunities for implementing an expansive approach to stigma prevention. The findings of this study will inform the development of a ‘universal precautions’ approach to BBV/STI-related stigma reduction in healthcare services.

Universal precautions refer to the range of practices for hygiene and infection control, which have been designed to be applied consistently to all healthcare patients or clients to prevent exposure to blood and bodily fluids and ensure that specific groups of people are not unfairly targeted or stigmatised. Recent scholarship theorises how a universal precautions approach could inform initiatives to reduce stigma in healthcare settings (Treloar et al., 2022) but as yet, there is limited knowledge as to how a universal precautions approach to stigma could be usefully applied to BBVs and STIs. A universal precautions approach to stigma (and quality of care) operates from the position that (1) all patients affected by BBVs and STIs are likely to have experienced a form of stigma in healthcare settings and as such may be fearful of exclusion or poor treatment on the basis of one or more attributes, conditions, practices, or identities, (2) that multiple settings and situations might give rise to stigma and discrimination (whether intended or not), and (3) that this fundamentally undermines provision of effective healthcare.

By analysing data drawn from interviews with key stakeholders and clinical and non-clinical healthcare professionals, this project promises to make a significant contribution to developing a new approach to addressing BBV and STI-related stigma and discrimination within healthcare settings, with the ultimate goal of improving the quality of care provided to affected populations.

Project activities

Recruitment of key stakeholders involved in healthcare provision and policy for people living with and affected by BBVs and STIs is currently underway.

The project team comprises:

Chief investigators

Professor Carla Treloar, Centre for Social Research in Health, UNSW Sydney

Professor Suzanne Fraser, Australian Research Centre in Sex, Health and Society, La Trobe University

Professor Mark Stoové, Burnet Institute

Dr Amy Kirwan, Burnet Institute

Professor Virginia Wiseman, Surveillance and Evaluation Research Program, UNSW Sydney

Dr Caroline Watts, Surveillance and Evaluation Research Program, UNSW Sydney

Mr Robert Monaghan, Surveillance and Evaluation Research Program, UNSW Sydney

Dr Adrian Farrugia, Australian Research Centre in Sex, Health and Society, La Trobe University

Project coordinator

Dr Elena Cama, Centre for Social Research in Health, UNSW Sydney

ARCSHS Project staff

Ms Emily Lenton, Australian Research Centre in Sex, Health and Society, La Trobe University

Ms Gemma Nourse, Australian Research Centre in Sex, Health and Society, La Trobe University

References

Treloar, C., Cama, E., Lancaster, K., Brener, L., Broady, T., Cogle, A. & O’Donnell, D. (2022). A universal precautions approach to reducing stigma in health care: Getting beyond HIV-specific stigma. Harm Reduction Journal, 19 (74), 1-5.