Survival, safety and belonging: An ethnographic study of experiences and perceptions of people who inject drugs accessing a supervised injecting Centre

Abstract

Introduction: The inclusion of people who use drugs in the design and evaluation of their health services remains a relatively new phenomenon. The aim of the research was to explore the experiences and perceptions of people accessing the Medical Supervised Injecting Centre (MSIC), and Clinic 180, Sydney Australia, and the factors facilitating and inhibiting their participation. The research was undertaken within a framework of critical ethnography. Methods: Twenty-three participants who inject drugs at the MSIC and five from Clinic 180 who chose not to use the MSIC were interviewed using semi-structured interviews to hear and raise their experiences and perceptions of these services within their everyday lives. Results: People who accessed the MSIC narrated a sense of personhood, survivor-hood, community and belonging. The overarching emerging theme was “I’m Human.” People who accessed The Clinic services spoke of the MSIC as reinforcing the stigmatisation of the “users” and increasing the temptation to continue to inject drugs. Discussion: This research gathered the experiences and perceptions of people accessing MSIC and Clinic 180. This can inform and reinforce public health and harm reduction approaches that embrace trauma informed care and social justice actions. This research also demonstrates the alignment between critical ethnography and the emerging models of co-design, co-production and health partnerships, sharing the shifting of power relations. Conclusion: The experiences and perceptions of people who inject drugs, and an understanding of their everyday lives, are essential to the design and evaluation of the services they access.