What do needle and syringe programs do? An assemblage approach

Stream: Stigma 1
Date: Thursday, 31 March 2016
Time: 1.45 pm – 3.00 pm

Abstract

Objective: To understand the experience of NSP service engagement from the perspective of NSP clients and NSP workers, and in doing so, answer the broader theoretical question of "what do NSPs do?".

Approach: Semi-structured, in-depth interviews were conducted, using a convenience sample of 31 clients, and all 12 workers, at NSPS across two local health districts in Western Sydney over the course of 2012 and 2013. Interview transcripts were coded and analysed using an assemblage theory framework, with the aid of qualitative data analysis software.

Findings: A range of factors were involved in service access that were not directly related to obtaining injecting equipment. Some of these included material needs such as clothing or sleeping bags. Others concerned simply having another human being to talk to, or to experience a social encounter that was not stigmatising. NSP workers and service provision more generally were subjected to discriminatory attitudes and practices from other, non-NSP health workers, which in some circumstances obstructed service provision. NSP workers engaged in emotional labour, rapport-building and impression management (face work) to facilitate better relations between NSPs and non-NSP health workers, in turn establishing the conditions for future service provision.

Implications: While the distribution of sterile injecting equipment is and should be core business, the work of NSPs is always already in excess of distribution. The approach taken by the present research suggests some novel possibilities for understanding how discrimination and marginalisation can be understood in the context of service engagement and service provision.

Author

Kenneth Yates (Presenter), Centre for Social Research in Health
Kenneth is a PhD candidate at the Centre for Social Research in Health. His research concerns staff and client experiences of needle and syringe programs in Western Sydney.