Mapping experiences of workplace stigma and discrimination within the lived-living experience of illicit drug use and bloodborne virus peer workforce: a scoping review

Peer workers with lived-living experience of illicit drug use and/or bloodborne viruses are critical in linking community with health services and programs. Despite the increasing demand for, and recognition of, the value and contributions of peer workers, the risk of workplace stigma and discrimination due to their lived-living experience remains a persistent issue. This scoping review aims to map available literature about workplace stigma and discrimination against peer workers with lived-living experience of drug use or bloodborne virus. The methods used in this scoping review were guided by the Joanna Briggs Institute methodology. A Population-Context-Concept format was used to develop search strategies conducted across four databases to assess articles for eligibility. Community representatives from Australian national and state-based peer-led Drug User Organisations provided input and expertise into all components of this review. Data was extracted and analysed from 61 articles that met the inclusion criteria. Findings were mapped against five levels the Socioecological Model of Health framework, and presented as key risk factors that either increase vulnerability to or sustain stigma and discrimination in the workplace, or protective factors that promote resilience and positive workplace experiences for peer workers. This review highlights that workplace stigma and discrimination towards peer workers takes many forms, including increased emotional labour, negative attitudes or behaviours towards peer workers from non-peer staff, disparities in working conditions between peer workers and non-peer staff, and law enforcement activities that impact peer work. Workplace stigma and discrimination experienced by peer workers can be addressed through adequate planning and the development of organisations and systems that address and acknowledge the existence of stigma and work to create safe work environments for peer workers. This includes organisational policies and training which recognises the unique emotional burdens experienced by peer work and addresses unequal employment conditions between peer- and non-peer staff, and broader societal changes around how drug use is policed.