General Beliefs and Stigma Regarding Illicit Drug Use: Perspectives of Family Members and Significant Others of Drug Users in an Inner City in Brazil

Family Perspectives on Stigma Toward Women Who Use Drugs in Tanzania

The stigma surrounding drug use adversely affects the health and wellbeing of people who use drugs. With projected increases in drug use in Africa over the next decade, understanding public perceptions of drug use is critical. This study explores perceptions and attitudes toward illicit drug use from the viewpoint of the families of women who use drugs. In March 2019, we conducted semi-structured interviews with 19 family members of women who use drugs in Dar es Salaam, Tanzania. The interviews included a closed-ended survey and open-ended questions about drug use attitudes. We thematically analyzed open-ended responses and summarized survey response frequencies. Three key themes emerged: (1) disapproval and stigma regarding drug use, (2) increased stigma and social consequences for women who use drugs, and (3) empathy and a call for support and intervention. Participants viewed people who use drugs negatively, associating them with danger and criminality. Women faced harsher judgment due to cultural expectations of femininity and motherhood. Despite these negative perceptions and attitudes, participants wanted to support people who use drugs, advocating for better access to treatment. Culturally tailored, gender-sensitive interventions are essential to reduce stigma and improve outcomes for these women and their families.

The joy and pain of being a harm reduction worker: a qualitative study of the meanings about harm reduction in Brazil

BACKGROUND

Although harm reduction is highlighted as an effective intervention for alcohol and drug use, a funding gap for harm reduction interventions has been identified, mainly in low- and middle-income countries. In these countries, tensions between abstinence and harm reduction models have impaired the shift from punitive practices to evidence-based interventions committed to guaranteeing the human rights of people who use drugs. Since 2015, the Brazilian government has adopted a more punitive and abstinence-focused drug policy that jeopardizes the care of people who use alcohol and other drugs and the comprehension of the harm reduction workers' perspective in relation to their practice. Therefore, this study aimed to comprehend the meanings constructed by Brazilian harm reduction workers regarding their practices with vulnerable populations amidst a context of political tension.

METHODS

We conducted 15 in-depth semi-structured qualitative interviews with harm reduction workers employed in public health services for at least 6 months. Data were analyzed using thematic analysis.

RESULTS

The thematic axis "The joy and pain of being a harm reduction worker in Brazil" was constructed and divided into four major themes: (1) Invisibility of harm reduction work; (2) Black, poor, and people who use drugs: identification with the service users; (3) Between advocacy and profession: harm reduction as a political act; (4) Small achievements matter. Despite the perceived invisibility of harm reduction workers in the public health and alcohol and drug fields, valuing small achievements and advocacy were important resources to deal with political tension and punitive strategies in Brazil. The findings also highlight the important role of harm reduction workers due to their personal characteristics and understanding of drug use behavior, which bring the target audience closer to actions within the public health system.

CONCLUSION

There is an urgent need to acknowledge harm reduction based on peer support as a professional category that deserves adequate financial support and workplace benefits. Additionally, expanding evidence-based harm reduction interventions and community-based voluntary drug use treatment centers should be prioritized by public policies to address the human rights violations experienced by people who use drugs.

ATTITUDES TOWARD PERSONS WHO ABUSE DRUGS IN ONE URBAN COMMUNITY ON THE ISLAND OF NEW PROVIDENCE, BAHAMAS

ABSTRACT Objective: to explore the attitudes toward persons who abuse drugs (alcohol, marijuana, and cocaine) in one urban community on the Island of New Providence, in the Bahamas. Method: a cross-sectional survey was utilized to get the data. The sample size was 126 respondents. Results: attitudes toward persons who abuse cocaine were significantly more negative compared to attitudes toward persons who abuse marijuana and alcohol. Age and level of educational attainment were associated with more negative attitudes toward persons who abuse cocaine. Personal use of marijuana and knowing someone who abused the substance were correlated with more positive attitudes toward persons who abuse marijuana. Conclusion: attitudes toward persons who abuse drug in the Bahamas varied depending on the type of drug abused.