Stigmatising space-times: Addressing healthcare stigma beyond interpersonal interactions.

Abstract

Stigma related to blood-borne viruses (BBVs) and sexually transmitted infections (STIs) has been shown to undermine the quality of healthcare. Given the pervasiveness and multiple manifestations of stigma within healthcare settings, recent research has argued that stigma should be addressed 'universally' i.e. for all stigmatising attributes and conditions, across all healthcare services. As part of the development of a universal approach to stigma, we analyse 20 interviews conducted with key stakeholders with expertise in BBVs, STIs and stigma in Australian healthcare settings. Inspired by research that addresses stigma as a biopolitical and spatial-temporal phenomenon, we examine how stigma weaves through relationships between people, time, space and technologies of healthcare provision. We begin with a discussion of funding structures and time constraints, followed by an examination of matters relating to the geographical location of the clinic and, finally, an analysis of smaller scale service environment space-times. In doing so, we bring attention to significant spatial-temporal matters that shape the production of stigma and address the need to balance universal concerns about healthcare quality with the specific forms of stigma that can emerge in relation to particular health issues and populations, such as BBVs and STIs. Overall, we examine how ambitious responses to stigma such as that proposed by the 'universal precautions' approach broaden our focus beyond interpersonal interactions and help draw attention to a wider range of objects, spaces and temporal dynamics that must be addressed in any effort to address stigma.