Estigma social en madres puertorriqueñas usuarias de heroína: Una exploración de las voces femeninas y su entorno social

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Abstract

El estigma social se ha convertido en una barrera para la salud pública en poblaciones de alto riesgo. Este es el caso de las madres usuarias de heroína en Puerto Rico, quienes han tenido que vivir en la sombra de la exclusión, marginación y discriminación por el estigma social asociado al consumo de drogas y a la imagen de la mujer usuaria. Utilicé una metodología cualitativa y análisis de discurso para explorar experiencias de cinco mujeres usuarias de heroína, cinco personas proveedoras de servicios y cuatro personas de apoyo social que fueron entrevistadas a profundidad. Discuto el doble estigma de desigualdad de género y usuarias de sustancias que sufren las mujeres. El estigma social promueve el carecimiento de tratamientos adecuados en mujeres usuarias en Puerto Rico.

Translated abstract

Social stigma has become a barrier for public health in high-risk populations. This is the case of heroin using women and mothers in Puerto Rico, who have had to live in exclusion, marginalization, and discrimination because of the social stigma associated with the consumption of drugs and its image. I used a qualitative methodology and discourse analysis to explore the experiences of five (5) mothers that used heroin, five (5) service providers and four (4) social support sources who were interviewed in depth. I discuss the double stigma of gender inequality and substance users that women suffer. Social stigma promotes the lack of adequate treatments for heroin using women in Puerto Rico.

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Stigma, discrimination and the health of illicit drug users.

Jennifer Ahern, Jennifer Stuber, Sandro Galea (2007)

Persons who use illicit drugs are stigmatized in the United States. The conferral of a deviant social status on illicit drug users may serve to discourage use. However, stigmatization may also adversely affect the health of those who use illicit drugs, through exposure to chronic stress such as discrimination and as a barrier to accessing care. We hypothesized that aspects of stigma and discrimination would be associated with mental and physical health among illicit drug users. Using street outreach techniques, 1008 illicit drug users were interviewed about stigma and discrimination related to their drug use, and their health. We measured discrimination related to drug use, alienation, perceived devaluation, and responses to discrimination and stigma. Health measures included mental and physical health measures from the Medical Outcomes Study Short Form-36, depression symptoms from the Center for Epidemiological Studies Depression scale, and a sum of health conditions. In adjusted models, discrimination and alienation were both associated with poorer mental health, and only discrimination was associated with poorer physical health. Angry responses to discrimination and stigma were associated with poorer mental health. The association of stigma and discrimination with poor health among drug users suggests the need for debate on the relative risks and benefits of stigma and discrimination in this context.