耻辱在阻碍旧金山实施减少伤害服务中的作用
Christopher F Akiba1, Cariné E Megerian1, Esther O Chung1
1RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC, 27709, USA.
SSM. Qualitative research in health
|December 15, 2025
概括
旧金山的减少伤害服务面临着严重的多层次的耻辱,影响员工和计划交付. 解决这种耻辱对于持续的资金和改善吸毒者 (PWUD) 的健康结果至关重要.
科学领域:
- 公共卫生 公共卫生
- 社会学 社会学 社会学
- 成研究 研究成研究
背景情况:
- 美国面临着严重的过量使用流行病,减少危害的服务对于使用毒品的人 (PWUD) 证明是有效的.
- 旧金山在实施和维持减少危害计划方面有着悠久的历史.
- 最近的国家紧急情况强调,需要审查当前减少危害服务提供方面的挑战.
研究的目的:
- 质量地探索旧金山减少危害服务提供商的经验.
- 识别对减少危害计划实施和可持续性的障碍.
- 了解耻辱对减少伤害服务和工作人员的影响.
主要方法:
- 在2023年进行的定性研究.
- 深度采访来自旧金山10个社区组织的领导者,经理和前线工作人员.
- 使用反思性主题分析分析数据.
主要成果:
- 参与者报告了针对使用毒品的人 (PWUD),减少伤害提供商和服务的多层次耻辱.
- 耻辱感被收入不平等和 gentrification 等社会经济因素加剧,导致公共吸毒和露天市场.
- 官员的反伤害减轻言论和错误信息使服务变得政治化,导致资金不足,员工倦怠,创伤和流动,阻碍了计划的有效性.
- 互助部分缓解了这些障碍,但并没有完全消除它们.
结论:
- 多层次的污名化对减少伤害服务的有效实施和可持续性构成重大威胁.
- 直接解决污名化问题对于克服实施挑战和确保足够的持续资金至关重要.
- 针对耻辱感可以改善服务提供和提高吸毒者 (PWUD) 的健康结果.
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