Provider Stigma Can Prevent Injection Drug Users from Receiving HIV PrEP


Bias against injection drug users can inhibit them from receiving potentially lifesaving care, such as HIV pre-exposure prophylaxis (PrEP). Community-based responses like syringe service programs help combat this stigma.

Despite being at high risk for HIV infection, only 1-2% of people who inject drugs use preventative pre-exposure prophylaxis (PrEP).

Suzan Walters, PhD, is a sociologist who takes special interest in health disparities among stigmatized populations, such as injection drug users. “We have wonderful biomedical interventions, tools to treat, tools to prevent, such as PrEP…What I’d like to bring to the table is thinking of social responses and collaboration to prevent HIV,” Walters said.

Walters describes syringe service programs (SSPs) as spaces where injection drug users can receive care in a safe, hygienic environment free of stigma. SSPs are also important because they provide injection drug users with education about harm-reduction tools, such as PrEP.

Walters interviewed with Contagion to discuss her recently published paper, “PrEP Care Continuum Engagement Among Persons Who Inject Drugs: Rural and Urban Differences in Stigma and Social Infrastructure.”

Like the rest of us, Walters said, healthcare providers are not exempt from the influence of stigma, and specifically the negative stigma toward people who inject drugs. However, the stakes of PrEP provider stigma are much higher, as these biases could be preventing injection drug users from receiving lifesaving care.

Walters advocated for thinking about stigma on the individual, community, and structural levels. “My dream and hope for this work is for there to be some real-world impact,” she said.

Suzan Walters, PhD, is a Research Assistant Professor in the NYU School of Global Public Health, affiliated investigator at the Center for Drug Use and HIV/HCV Research, and faculty affiliate at the Center for Opioid Epidemiology and Policy.

This is the second of a 2-part interview with Suzan Walters, PhD. You can find the first segment of Walters’s interview here, and the original coverage of Walters’s research here.

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