Centre for Social Research in Health
Stigma Research Stream
Published on the 03 July 2024
In Australia, there are currently five national strategies addressing HIV, hepatitis B and hepatitis C, and sexually transmissible infections. These strategies represent a coordinated response to reduce the transmission, morbidity and mortality associated with these infections. Each strategy contains its own set of objectives, with progress monitored via a set of related indicators. A clear objective exists within each of the five strategies to “eliminate the negative impact of stigma, discrimination, and legal and human rights issues on people’s health”. This is in recognition of the well known detrimental effects of stigma and discrimination, including on physical and mental health, and in discouraging people from accessing health care.
The Stigma Research Stream documents and monitors the experiences and expression of stigma and discrimination targeted at people affected by blood borne viruses and sexually transmissible infections. Priority populations include men who have sex with men, people who inject drugs, people living with HIV, people living with viral hepatitis (B and C) and people who engage in sex work. This stream also involves development and implementation of new and novel interventions to address stigma and discrimination, particularly in health care contexts, and ultimately improve the quality of care provided to these priority groups.
Research Centre
Research Area
Stigma and Discrimination
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This study aims to monitor stigma among priority groups identified by the five national strategies addressing blood borne viruses and sexually transmissible infections. An indicator of the experience of stigma is included in ongoing routine surveys among a range of populations, including men who have sex with men, people who inject drugs, people living with HIV, people living with viral hepatitis (B and C) and people who engage in sex work. A mirrored indicator measuring the expression of stigma is included in ongoing surveys of health providers and the general public. This study is funded by the Australian Government Department of Health.
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The aim of this suite of projects is to review existing literature about stigma reduction initiatives, and then to develop, implement and evaluate new theoretically-informed interventions with key target groups. These interventions will include initiatives aimed at the general public and health workers, and cover individually and organisationally-based strategies for change. One such project is the Universal Precautions project, which seeks to develop and trial a world-first systemic approach to stigma reduction by leveraging health system precepts of equity, access, and quality. The Universal Precautions project is funded by the Australian Government Department of Health.
- Collaborators
- Publications
Brener, L., Cama, E., Broady, T., Harrod, M., Holly, C., Caruana, T., … & Treloar, C. (2024). Experiences of stigma and subsequent reduced access to health care among women who inject drugs. Drug and Alcohol Review, advance online publication.
Brener, L., Caruana, T., Cama, E., Gilford, C., Crawford, S., Capell-Hattam, T., & von Hippel, C. (2024). Stigma by association among alcohol and other drug and harm reduction workers: Implications for workplace outcomes. Drug and Alcohol Review, advance online publication.
Broady, T. R., Valerio, H., Alavi, M., Wheeler, A., Silk, D., Martinello, M., Conway, A., Milat, A., Dunlop, A., Murray, C., Henderson, C., Amin, J., Read, P., Marks, P., Degenhardt, L., Stevens, A., Prain, B., Hayllar, J., Reid, D., Montebello, M., … ETHOS Engage Study Group (2024). Factors associated with experiencing stigma, discrimination, and negative health care treatment among people who inject drugs. International Journal on Drug Policy, 128, 104468.
Cama, E., Brener, L., Horwitz, R., Broady, T., Vu, K., Jin, D., Wu, E., & Treloar, C. Factors associated with hepatitis B knowledge among people of Vietnamese ethnicity in Australia. Psychology Health and Medicine, advance online publication.
Cama, E., Brener, L., Broady, T., Horwitz, R., Jin, D., Vu, K., Wu, E., & Treloar, C. (2024). Hepatitis B screening and knowledge among Chinese and Vietnamese students in Australia. PLOS One, 19(3), e0299224.
Caruana, T., Brener, L., Calabrese, S. K., Cama, E., Treloar, C., & Broady, T. (2024). Differences in stigma reduction related to injection drug use between people expressing conservative, moderate and progressive values following an online intervention.Drug and Alcohol Review,43(4), 853–860.
Sutherland, R., King, C., Karlsson, A., Treloar, C., Broady, T., Chandrasena, U., Salom, C., Dietze, P., & Peacock, A. (2024). Stigma, and factors associated with experiencing stigma, while visiting health-care services among samples of people who use illegal drugs in Australia. Drug and Alcohol Review, advance online publication.
Brener, L., Broady, T. Cama, E. & Treloar. (2023). The impact of sources of stigma on health care avoidance among gay and bisexual men in Australia. AIDS Care, 35(5), 663-671.
Broady, T., Brener, L., Caruana, T., Cama, E., & Treloar, C. (2023). Factors associated with sharing equipment among people who inject drugs: The role of community attachment in harm reduction and health promotion. Drug and Alcohol Review, 42(3), 561-568.
Broady, T., Brener, L., Horwitz, R., Cama, E., & Treloar, C. (2023). Reducing stigma towards people living with HIV and people who inject drugs using social norms theory: An online study with Australian health care workers. Drug and Alcohol Dependence, 249, 109953.
Schroeder, S. E., Treloar, C., Bourne, A., Stoové, M., Doyle, J., Hellard, M., & Pedrana, A. (2023). Pre-Empting Stigma and Complicating Trauma: Narratives of Gay and Bisexual Men who Inject Drugs in Australia. Qualitative Health Research, 33(8-9), 688–700.
Sivak, L., Reilly, R., Lockton, J., Treloar, C., Roe, Y., McKetin, R., Butt, J., Ezard, N., Winkenweder, H., & Ward, J. (2023). Psychosocial stress and methamphetamine use: A mixed-methods study of intersectional stigma and Aboriginal and Torres Strait Islander methamphetamine use. International Journal on Drug Policy, 121, 104189.
Brener, L., Cama, E., Broady, T., Hopwood, M. & Treloar, C. (2022). Comparing Australian health worker and student attitudes and concerns about providing care to people living with hepatitis B. Health Promotion Journal of Australia, 33(1), 282-288.
Brener, L., Caruana, T., Broady, T., Cama, E., Ezard, N., Madden, A. & Treloar, C. (2022). Addressing injecting related risks among people who inject both opioids and stimulants: Findings from an Australian survey of people who inject drugs. Addictive Behaviors Reports, 15, 100398.
Horwitz, R., Brener, L., Marshall, A. D., Caruana, T., & Newman, C. E. (2022). Optimising community health services in Australia for populations affected by stigmatised infections: What do service users want? Health and Social Care in the Community, 30,e3686–e3695.
Jin, D., Brener, L., & Treloar, C. (2022). Hepatitis B-related stigma among Chinese immigrants living with hepatitis B virus in Australia: A qualitative study. Health and Social Care in the Community,30,5602–e5611.
Jin, D., Brener, L., & Treloar, C. (2022). Knowledge and beliefs about hepatitis B virus infection and associated factors among Chinese migrants in Australia: The result of a quantitative study. Health and Social Care in the Community, 30(3), 918-925.
Jin, D., Treloar, C., & Brener, L., (2022). Hepatitis B virus related stigma among Chinese living in mainland China: a scoping review. Psychology, Health and Medicine, 27(8), 1760-1773.
Treloar, C., Cama, E., Lancaster, K., Brener, L., Broady, T.R., Cogle, A. & O’Donnell, D. (2022). A universal precautions approach to reducing stigma in health care: Getting beyond HIV specific stigma. Harm Reduction Journal, 19, 74.
Treloar, C., Lancaster, K., Gendera, S., Rhodes, T., Shahbazi, J., Byrne, M., Degenhardt, L., & Farrell, M. (2022). Can a new formulation of opiate agonist treatment alter stigma?: Place, time and things in the experience of extended-release buprenorphine depot. International Journal of Drug Policy, 107, 103788.
Brener, L., Broady, T., Cama, E., Hopwood, M., Byrne, J. & Treloar, C. (2021). Positive effects of community attachment on internalised stigma and wellbeing among people who inject drugs. International Journal of Drug Policy, 97, 103323.
Broady, T. R., Brener, L. Vuong, T., Cama, E., & Treloar, C. (2021). Online interventions to reduce stigma towards population groups affected by blood borne viruses in Australia. International Journal of Drug Policy, 96, 103292.
Cama, E., Brener, L., Broady, T., Hopwood, M. & Treloar, C. (2021). Australian health and medical workers’ concerns around providing care to people living with hepatitis B. Health & Social Care in the Community, 29(6), e431-e439.
Djordjevic, F., Ryan, K., Gunn, J., Brener, L., O’Keefe, D., Draper, B., Schroeder, S., Gold, J., Treloar, C., Broady, T., Dietze, P., Hellard, M., & Pedrana, A. (2021). Health service utilization and experiences of stigma amongst people who inject drugs in Melbourne, Australia. Journal of Viral Hepatitis, 28(12), 1738- 1743.
Stardust, Z., Treloar, C., Cama, E., Kim, J. (2021). ‘I Wouldn’t call the cops if i was being bashed to death’: Sex work, whore stigma and the criminal legal system. International Journal for Crime, Justice and Social Democracy, 10(3), 142-157.
Treloar, C., Hopwood, M., Drysdale, K., Lea, T., Holt, M., Dowsett, G. W., Aggleton, P., & Bryant, J. (2021). Stigma as understood by key informants: A social ecological approach to gay and bisexual men's use of crystal methamphetamine for sex. International Journal of Drug Policy, 94, 103229 – 103229.
Treloar, C., Stardust, Z., Cama, E., & Kim, J. (2021,). Rethinking the relationship between sex work, mental health and stigma: a qualitative study of sex workers in Australia. Social Science and Medicine, 268, 113468.
Broady, T.R., Brener, L., Cama, E., Hopwood, M., & Treloar, C. (2020). Stigmatising attitudes towards injecting drug use, blood borne viruses, and sexually transmissible infections in a representative sample of the Australian public. PLOS ONE, 15(4), e0232218.
Brener, L., Broady, T., Cama, E., Hopwood, M., de Wit, J.B.F., & Treloar, C. (2020). The role of social support in moderating the relationship between HIV centrality, internalised stigma and psychological distress for people living with HIV. AIDS Care, 32(7), 850-857.
Broady, T.R., Brener, L., Hopwood, M., Cama, E., Treloar, C., & Holt, M. (2020). HIV stigma by association among Australian gay and bisexual men. AIDS, 34(Suppl 1), S53-S61. doi:
Cama, E., Brener, L., Slavin, S., & de Wit, J. (2020). The relationship between negative responses to HIV status disclosure and psycho-social outcomes among people living with HIV. Journal of Health Psychology, 25(4), 538-544.
Hopwood, M., Cama, E., de Wit, J., & Treloar, C. (2020). Stigma, Anxiety, and Depression Among Gay and Bisexual Men in Mixed-Orientation Marriages. Qualitative Health Research, 30(4), pp. 622 – 633.
Rance, J., Lafferty, L., & Treloar, C. (2020). ‘Behind closed doors, no one sees, no one knows’: hepatitis C, stigma and treatment-as-prevention in prison. Critical Public Health, 30(2), 130-140.
Brener, L., Cama, E., Broady, T.R., Hopwood, M., de Wit, J., & Treloar, C. (2019). Predictors of health care workers’ support for discriminatory treatment and care of people who inject drugs. Psychology, Health & Medicine, 24(4), 439-445.
Broady, T.R., Cama, E., Brener, L., Hopwood, M., de Wit, J., & Treloar, C. (2018). Responding to a national policy need: Development of a stigma indicator for blood borne viruses and sexually transmissible infections. Australian & New Zealand Journal of Public Health, 42(6), 513-515.
Madden, A., Hopwood, M., Neale, J., & Treloar, C. (2018). Beyond interferon side effects: What residual barriers exist to DAA hepatitis C treatment for people who inject drugs? PLoS ONE, 13(11), e0207226.
Rose, G., von Hippel, C., Brener, L., & von Hippel, B. (2018). Attitudes of people working in mental health non-governmental organisations in Australia: A comparison with other mental health professionals. Health Psychology Open, 5(1).
von Hippel, C., Brener, L., & Horwitz, R. (2018). Implicit and explicit internalized stigma: Relationship with risky behaviors, psychosocial functioning and healthcare access among people who inject drugs. Addictive Behaviors, 76, 305-311.
Brener, L., Cama, E., Hull, P., & Treloar, C. (2017). Evaluation of an online injecting drug use stigma intervention targeted at health providers in New South Wales, Australia. Health Psychology Open, 4(1).
Fraser, S., Pienaar, K., Dilkes-Frayne, E., Moore, D., Kokanovic, R., Treloar, C., & Dunlop, A. (2017) Addiction stigma and the biopolitics of liberal modernity: A qualitative analysis. International Journal of Drug Policy, 44, 192-201.
Brener, L., von Hippel, C., Wilson, H., & Hopwood, M. (2016). Health workers' support for hepatitis C treatment uptake among clients with a history of injecting. Journal of Health Psychology, 23(8), 1012-1018.
Brener, L., Wilson, H., Jackson, L. C., Johnson, P., Saunders, V., & Treloar, C. (2016). Experiences of diagnosis, care and treatment among Aboriginal people living with hepatitis C. Australian and New Zealand Journal of Public Health, 40(S1), S59-S64.
Cama, E., Brener, L., Wilson, H., & von Hippel, C. (2016). Internalized Stigma Among People Who Inject Drugs. Substance Use and Misuse, 51(12), 1664-1668.
Treloar, C., Jackson, L. C., Gray, R., Newland, J., Wilson, H., Saunders, V., Johnson, P., & Brener, L. (2016). Multiple stigmas, shame and historical trauma compound the experience of Aboriginal Australians living with hepatitis C. Health Sociology Review, 25(1), 18 - 32,
Treloar, C., Rance, J., Yates, K., & Mao, L. (2016). Trust and people who inject drugs: The perspectives of clients and staff of Needle Syringe Programs, International Journal of Drug Policy, 27, 138-145.
Brener, L., Horwitz, R., Von Hippel, C., Bryant, J., & Treloar, C. (2015). Discrimination by health care workers versus discrimination by others: Countervailing forces on HCV treatment intentions. Psychology, Health & Medicine, 20(2), 148-153.
Cama, E., Brener, L., Slavin, S., & de Wit, J. (2015). The impact of HIV treatment-related stigma on uptake of antiretroviral therapy, AIDS Care, 27(6), 739-742.
Cama, E., Wilson, H., Mackenzie, A., & Brener, L. (2015). Hepatitis C Stigma and Empowerment Through Positive Speaking in Sydney, Australia. Journal of Community and Applied Social Psychology, 25(5), 418-431.
Treloar, C., Hopwood, M., Yates, K., & Mao, L. (2015). Doing the devils work": Emotional labour and stigma in expanding Needle and Syringe Programs. Drugs: Education, Prevention and Policy, 22(5), 437-443.
Wilson, H., Brener, L., Mao, L., & Treloar, C. (2014). Perceived discrimination and injecting risk among people who inject drugs attending Needle and Programmes in Sydney, Australia. Drug and Alcohol Dependence, 144, 274-278.
Brener, L., Callander, D., Slavin, S., & de Wit, J. (2013). Experiences of HIV stigma: the role of visible symptoms, HIV centrality and HIV-positive community attachment for people living with HIV. AIDS Care, 25(9), 1166-1173.
Brener, L., Ellard, J. M., Murphy, D. A., & Callander, D. (2013). Perceptions and deflections: Associations between attitudes towards people with hepatitis C and testing for hepatitis C among Australian gay and bisexual men. Sexual Health, 10(3), 268-274.
Brener, L., Rose, G., Treloar, C., Cama, E., & Whiticker, M. (2013). Mental health support workers' attitudes towards hepatitis C and injecting drug use: Barriers to recovery? Mental Health and Substance Use, 7(3), 217-229.
Brener, L., Rose ,G., von Hippel, C., & Wilson, H. (2013). Implicit attitudes, emotions and helping intentions of mental health workers towards their clients. Journal of Nervous and Mental Disease, 201(6), 460-463.
Brener, L., von Hippel, C., Horwitz, R., & Hamwood, J. (2013). The impact of pluralistic ignorance on the provision of health care for people who inject drugs. Journal of Health Psychology, 20(9), 1240-1249.
Brener, L., Wilson, H., Slavin, S., & de Wit, J. (2013). The impact of living with HIV: Differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia. Sexual Health, 10(4), 316-319.
Deacon, R. M., Mooney-Somers, J., Treloar, C., & Maher, L. (2013). At the intersection of marginalised identities: Lesbian, gay, bisexual and transgender people's experiences of injecting drug use and hepatitis C seroconversion. Health and Social Care in the Community, 21(4), 402-410.
Rose, G., Cama, E., Brener, L., & Treloar, C. (2013). Knowledge and attitudes towards hepatitis C and injecting drug use among mental health support workers of a community managed organisation. Australian Health Review, 37(5), 654-659.
Treloar, C., Rance, J., & Backmund, M. (2013). Understanding barriers to hepatitis c virus care and stigmatization from a social perspective. Clinical Infectious Diseases, 57(S2), S51-S55.
Treloar, C., Rance, J., Grebely, J., & Dore, G. J. (2013). Client and staff experiences of a co-located service for hepatitis C care in opioid substitution treatment settings in New South Wales, Australia. Drug and Alcohol Dependence, 133(2), 529-534.
Brener, L., Wilson, H., Rose, G., Mackenzie, A., & de Wit, J. (2012). Challenging stereotypes and changing attitudes: improving quality of care for people with hepatitis C through Positive Speakers programs. Psychology, Health & Medicine, 18(2), 242-249.
Resnick, I., Brener, L., Treloar, C., & Hull, P. B. (2012). Health worker attitudes towards peer workers in hepatitis C prevention. Psychology, Health & Medicine, 17(6), 659-666.
Rose, G., Beale, I., Malone, J., Higgin, J., Whiticker, M., & Brener, L. (2012). Problematic substance use in two mental health NGOs, and staff, client and general public attitudes towards problematic substance use amongst people with mental illness. Mental Health and Substance, 5(4), 275-286.
von Hippel, C., & Brener, L. (2011). Specificity of discrimination: Does it matter from whence it comes? Journal of Applied Social Psychology, 42(4), 1029-1042.
Brener, L., von Hippel, W. H., Kippax, S. C., & Preacher, K. (2010). The role of physician and nurse attitudes in the health care of injecting drug users. Substance Use and Misuse, 45(7-8), 1007-1018.
Brener, L., von Hippel, W. H., von Hippel, C., & Treloar, C. (2010). Perceptions of discriminatory treatment by staff as predictors of drug treatment completion: utility of a mixed methods approach. Drug and Alcohol Review, 29(5), 491-497,
Hopwood, M. N., Nakamura, T., & Treloar, C. (2010). Disclosing hepatitis C infection within everyday contexts: Implications for accessing support and healthcare. Journal of Health Psychology, 15(6), 811-818.
Horwitz, R., Brener, L., Treloar, C., Sabri, W., Moreton. R., Sedrak, A. (2010). Hepatitis C in an Australian migrant community: knowledge of and attitudes towards transmission and infection. Contemporary Drug Problems, 37(4), 659-683.
Brener, L., & Treloar, C. (2009). Alcohol and other drug treatment experiences of hepatitis C-positive and negative clients: implications for hepatitis C treatment. Australian Health Review, 33(1), 100-106.
Brener, L., & von Hippel, W. H. (2008). Measuring attitudes towards injecting drug users and people with hepatitis C. Substance Use and Misuse, 43(3-4), 295-302.
von Hippel, W. H., Brener, L., Von Hippel, C. D. (2008). Implicit prejudice toward injecting drug users predicts intentions to change jobs among drug and alcohol nurses. Psychological Science, 19(1), 7-11.
Brener, L., Von Hippel, W. H., & Kippax, S. C. (2007). Prejudice among health care workers toward injecting drug users with hepatitis C: Does greater contact lead to less prejudice? International Journal of Drug Policy, 18(5), 381-387.
Hopwood, M. N., & Treloar, C. (2007). The drugs that dare not speak their name: Injecting and other illicit drug use during treatment for hepatitis C infection. International Journal of Drug Policy, 18(5), 374-380.
Hopwood, M. N., Treloar, C., & Bryant, J. (2006). Hepatitis C and injecting-related discrimination in New South Wales, Australia. Drugs: Education Prevention and Policy, 13(1), 61-75/
Fraser, S. & Treloar, C. (2006). `Spoiled identity` in hepatitis C infection: The binary logic of despair.Critical Public Health, 16(2), 99-110.
Treloar, C., & Holt, M. (2006). Deficit models and divergent philosophies: Service providers` perspectives on barriers and incentives to drug treatment. Drugs: Education Prevention and Policy, 13(4), 367-382.
Treloar, C., & Cao, W. (2005). Barriers to use of needle and syringe programs in a high drug use area of Sydney, New South Wales. International Journal of Drug Policy, 16(5), 308-315.
Treloar, C., & Hopwood, M. (2004). Infection control in the context of hepatitis C disclosure: implications for education of healthcare professionals. Education for health (Abingdon, England), 17(2), 183–191.
