title: Structural factors that promote stigmatization of drug users with hepatitis C in hospital emergency departments.
abstract: BACKGROUND
  Interventions to mediate the stigmatization of people affected with HCV, particularly those who use illicit drugs, have been largely focused on changing health care practitioners' attitudes and knowledge regarding Hepatitis C and illicit drug use and these have had disappointing results. There is a need for research that examines factors beyond individual practitioners that explains why and how stigmatization of the population occurs within health care and informs interventions to mitigate these factors.
  
  
  METHODS
  The research was intended to identify structural factors that contribute to the structural stigmatization of people within hospital Emergency Departments who are current users of illicit drugs and are HCV positive. The research had an interpretive description design and occurred in Nova Scotia, Canada. The year-long qualitative study entailed individual interviews of 50 service providers in hospital EDs or community organizations that served this population.
  
  
  RESULTS
  The research findings generated a model of structural stigmatization that greatly expands the current understanding of stigmatization beyond individual practitioners' attitudes and knowledge and internal structures to incorporate structures external to hospitals, such as physician shortages within the community and the mandate of EDs to reduce wait times.
  
  
  CONCLUSIONS
  The research reported herein has conceptualized stigmatization beyond an individualistic approach to incorporate the multifaceted ways that such stigmatization is fostered and supported by internal and external structures.
authors: Thompson Rivers University, School of Nursing, Canada. Electronic address: bapaterson@tru.ca.
authors: Barbara
authors: B
authors: Paterson
authors: Geri
authors: G
authors: Hirsch
authors: Karen
authors: K
authors: Andres
mesh_terms: D002170:Canada; D055030:Drug Users / Q000523:psychology*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006526:Hepatitis C / Q000523:psychology*; D006801:Humans; D036301:Qualitative Research; D013240:Stereotyping
keywords: Emergency departments; Hepatitis C; Illicit drug use; Structural stigmatization