Stigma and discrimination experienced by people who inject drugs: Tracks Enhanced Surveillance System

On this page

• Background
• Data source
• Sociodemographics
• Substance use
• Stigma and discrimination
• Acknowledgements
• Suggested citation
• Footnotes

Background

Stigma and discrimination, rooted in systemic inequities, create significant barriers that prevent people from accessing resources they need to be healthy. This includes services for sexually transmitted and blood-borne infections (STBBI). Access can be especially difficult for populations that experience disproportionate stigma and discrimination. This affects people who use drugs but particularly those who inject drugs.

Data source

Tracks is a surveillance^{Footnote 1} system led by the Public Health Agency of Canada (PHAC). Tracks collects both behavioral and biological data. It assesses the prevalence of STBBI among key populations. It also assesses related behaviors and structural factors, such as racism, incarceration, or housing, that may correlate with a risk of STBBI. Key populations are surveyed in participating sites across Canada. Tracks surveys are:

• anonymous
• periodic — they are done repeatedly over time
• multi-centre — they collect data from several locations
• cross-sectional — they represent a group of people at a single point in time

This data blog presents early results from Phase 5 of the Tracks survey among people who inject drugs. Phase 5 of this survey began in December 2023. It will continue until early 2025. A total of 13 sites are participating in this phase from across 7 provinces and 1 territory (British Columbia, Alberta, Saskatchewan, Ontario, Quebec, New Brunswick, Newfoundland, Yukon).

The Phase 5 survey among people who inject drugs included anyone 16 years or older who injected drugs in the past 6 months. So far, 1,173 people from 7 sites across Canada have participated. This blog uses preliminary findings from these sites (December 2023 to September 2024). A final report will be written when data collection in the remaining sites is complete.

Sociodemographics

Table 1 summarizes key sociodemographic factors of the survey participants. Many participants identified as white (59.9%) or Indigenous (43.0%). Most (86.2%) were between 25 and 54 years old. Most (62.4%) identified as a man and 35.2% as a woman (Table 1).

Table 1. Sociodemographics of participants in the Tracks survey of people who inject drugs in Canada, Phase 5, 2024

* Proportions do not add up to 100%. Options were not mutually exclusive as participants could select more than 1 response.

Substance use

All survey participants reported injecting drugs and 96.5% (n=1,119) also reported using substances (excluding alcohol) through non-injection methods. Examples of non-injection methods include:

• inhaling
• snorting
• eating
• drinking

Methamphetamine and fentanyl were the most common drugs used by injection and non-injection methods. It is important to note that participants may use more than 1 substance at the same time.

Stigma and discrimination

In the 12 months before the survey, the majority of participants (80.9%) experienced at least one form of stigma or discrimination. Participants reported experiencing stigma or discrimination for multiple reasons. The 5 most common reasons are shown in Figure 3.

Around half of participants (46.6%) avoided healthcare because of stigma and discrimination. Around a tenth (10.1%) avoided HIV testing for the same reasons.

Experiences of stigma and discrimination are rooted in structural barriers and are very prevalent among people who inject drugs. Stigma and discrimination are related to systemic attitudes towards life experiences or sociodemographic characteristics. This may create barriers to accessing prevention and healthcare services. It may also impact the health and wellbeing of people who inject drugs.

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Related resources

• PWID Phase 4 National Survey Report
• Sexually transmitted and blood-borne infections surveillance
• Impact of COVID-19 on STBBIs