Opioid Use Disorder Stigma and Support for Harm Reduction in Rural Counties.

Area of Science:

• Public Health
• Sociology
• Addiction Science

Background:

• The opioid crisis presents a significant public health challenge in the U.S., especially in rural Pennsylvania.
• Stigma surrounding opioid use disorder (OUD) acts as a barrier to treatment and hinders harm reduction programming in these communities.

Purpose of the Study:

• To identify distinct subgroups based on OUD stigma in rural Pennsylvania.
• To examine how these stigma subgroups differ in their support for various harm reduction strategies.

Main Methods:

• An observational, cross-sectional study was conducted with 252 rural Pennsylvanians.
• Latent class analysis identified four distinct stigma profiles.
• ANCOVAs were used to compare harm reduction support across these identified stigma classes.

Main Results:

• Four stigma classes were identified: high stigma (HS), high judgment/low stigmatizing behavior (HJ/LB), high stigmatizing behavior/low stigmatizing attitude (HB/LA), and low stigma (LS).
• The HS group showed significantly less support for safe injection sites, syringe services programs, fentanyl test strips, and Naloxone distribution compared to other groups.
• The HJ/LB group also demonstrated less support for harm reduction strategies compared to the LS group.

Conclusions:

• OUD stigma profiles vary significantly across rural Pennsylvania.
• These stigma profiles are directly associated with differing levels of support for essential harm reduction strategies.
• Interventions for harm reduction should be tailored to address specific stigma levels and inform targeted messaging for effective implementation.