Carla Treloar1, Jake Rance2, Kenneth Yates2, Limin Mao2. 1. Centre for Social Research in Health, The University of New South Wales, NSW 2052, Australia. Electronic address: c.treloar@unsw.edu.au. 2. Centre for Social Research in Health, The University of New South Wales, NSW 2052, Australia.
Abstract
AIMS: Interest in health-care related trust is growing with the recognition that trust is essential for effective therapeutic encounters. While most trust-related research has been conducted with general patient groups, the experiences of people who inject drugs cannot be understood without acknowledging the critical role social stigma plays in shaping (mis)trust, both generally and in regards to health services specifically. This study examined the experiences of trust among clients and staff of Needle and Syringe Programs (NSPs) in one area of Sydney, Australia. METHOD: In-depth interviews with 12 NSP staff and 31 NSP clients were conducted. Analysis was informed by a five component model of trust, with particular emphasis on the notion of "global trust" as encompassing experiences of stigma and other negative social processes related to injecting drug use. Participant experiences of trust in NSPs were compared with those within other drug-related health services. Particular attention was paid to understanding the relationship between 'identity' (as a drug user) and 'legitimacy' (as a service user) and the centrality of this relationship to the experience of global trust for PWID. RESULTS: Notions of identity and legitimacy were inextricably bound up with the stigmatisation of drug use, shaping participants' experiences and accounts of trust in NSPs and drug treatment services. Client participants reported high levels of trust in NSPs, especially when compared with drug treatment services, describing being treated like "any other person" even when negotiating 'sensitive' issues. NSP staff participants described the establishment of trust as not only underpinning their work with clients but as something that required ongoing renewal and demonstration. CONCLUSION: "Global trust" assists us to better understand the complex experiences shaping PWID decisions to engage with and trust health services. The high levels of trust reported between client and NSP need to be recognised as a valuable resource for the delivery of effective health care for people who inject drugs, including encouraging behaviours to support the prevention of blood-borne viruses.
AIMS: Interest in health-care related trust is growing with the recognition that trust is essential for effective therapeutic encounters. While most trust-related research has been conducted with general patient groups, the experiences of people who inject drugs cannot be understood without acknowledging the critical role social stigma plays in shaping (mis)trust, both generally and in regards to health services specifically. This study examined the experiences of trust among clients and staff of Needle and Syringe Programs (NSPs) in one area of Sydney, Australia. METHOD: In-depth interviews with 12 NSP staff and 31 NSP clients were conducted. Analysis was informed by a five component model of trust, with particular emphasis on the notion of "global trust" as encompassing experiences of stigma and other negative social processes related to injecting drug use. Participant experiences of trust in NSPs were compared with those within other drug-related health services. Particular attention was paid to understanding the relationship between 'identity' (as a drug user) and 'legitimacy' (as a service user) and the centrality of this relationship to the experience of global trust for PWID. RESULTS: Notions of identity and legitimacy were inextricably bound up with the stigmatisation of drug use, shaping participants' experiences and accounts of trust in NSPs and drug treatment services. Client participants reported high levels of trust in NSPs, especially when compared with drug treatment services, describing being treated like "any other person" even when negotiating 'sensitive' issues. NSP staff participants described the establishment of trust as not only underpinning their work with clients but as something that required ongoing renewal and demonstration. CONCLUSION: "Global trust" assists us to better understand the complex experiences shaping PWID decisions to engage with and trust health services. The high levels of trust reported between client and NSP need to be recognised as a valuable resource for the delivery of effective health care for people who inject drugs, including encouraging behaviours to support the prevention of blood-borne viruses.
Authors: Rebecca B Hershow; Michelle Gonzalez; Elizabeth Costenbader; William Zule; Carol Golin; Lauren Brinkley-Rubinstein Journal: AIDS Educ Prev Date: 2019-08
Authors: Dea L Biancarelli; Katie B Biello; Ellen Childs; M Drainoni; Peter Salhaney; Alberto Edeza; Matthew J Mimiaga; Richard Saitz; Angela R Bazzi Journal: Drug Alcohol Depend Date: 2019-03-08 Impact factor: 4.492
Authors: Suzan M Walters; Bethany Coston; Alan Neaigus; Alexis V Rivera; Lila Starbuck; Valentina Ramirez; Kathleen H Reilly; Sarah L Braunstein Journal: Int J Drug Policy Date: 2020-02-21
Authors: Harinder S Chahal; Marion G Peters; Aaron M Harris; Devon McCabe; Paul Volberding; James G Kahn Journal: Open Forum Infect Dis Date: 2018-12-26 Impact factor: 3.835
Authors: Shane R Mueller; Jason M Glanz; Anh P Nguyen; Melanie Stowell; Stephen Koester; Deborah J Rinehart; Ingrid A Binswanger Journal: Int J Drug Policy Date: 2021-01-08