“We don't get much of a voice about anything”: perspectives on photovoice among people who inject drugs

Abstract

BackgroundIn the context of the current US opioid crisis, people who inject drugs (PWID) are increasingly researched, but their ability to tell their own stories may be limited. Photovoice is a participatory action research method that allows participants to use photography to directly depict their experiences.MethodsWe conducted interviews with PWID (n = 33) as part of a qualitative study on the health needs of PWID in the USA to explore interest and acceptability of photovoice as a potential research method and way to share their voices.ResultsParticipants identified facilitators and barriers to participating in a future photovoice project. Facilitators included a chance to depict one’s unique experience, help others in need by sharing one’s own story, and photography being a more “comfortable” way to tell their stories than traditional research methods. Barriers included safety concerns, embarrassment, and ability to retain cameras. Participants also identified areas of sensitivity related to documenting drug use.ConclusionsWhile we found broad acceptability of photovoice, barriers would need to be addressed and additional training and support for research staff and potential participants related to the ethics of public photography and engaging PWID in photovoice research would be required.

“Normally I Try and Capture a Moment, and With This I Had to Create a Moment”: Implications of Anonymous Photography Protocols in Photovoice Research with People Who Inject Drugs

“…Benefits included: having a more significant role in the partnership, prompting reflective insight, and facilitating opportunities to speak out. This is consistent with existing research demonstrating PWUD appreciation for Photovoice (Switzer et al, 2015), and PWID finding meaning in telling their stories (Drainoni et al, 2019). Such findings support the use of more empowering, partnership-based protocols when working with PWUD.…”

“…This is even more problematic where such identification might result in discrimination or other harms. Drainoni et al (2019) noted these fears among PWID who worried about being identified. While identifying portions can be blurred, Bagnoli (2009) reminds us that blurring may cause additional stigma.…”

“…Photovoice has been used with populations that face stigma, such as those in the sex trade (Desyllas, 2014), homeless persons (Bredesen & Stevens, 2013), and people experiencing addiction (Miller Heery, 2013). PWID, specifically, find value in the opportunity to voice their experiences through a visual medium, and the potential to help their own community by educating others (Drainoni et al, 2019).…”

Role of peer educators in behaviour change communication interventions for HIV prevention among people who inject drugs: Systematic review article

“…In particular, the majority of the PWID showed behaviour changes regarding the sharing of equipment and engaging in safe sex practices. These results are explained by Drainoni et al (2019) and Gillespie, Lasu, and Sawatzky (2018) who point out that peer education is critical, because it involves a particular, trusting relationship between the educators and the current injection drug users. This finding can be explained by the diffusion of innovation theory, which posits that certain people can influence behaviour changes through diffusing information and influencing the target group.…”

A Discussion of Harm Reduction for Algorithmic Fairness: Lessons from the Opioid Crisis

“…Importantly, the framework offered by Altman et al seeks to avoid disproportionate harms on minority groups and group punishment. I extend this harm reduction approach to algorithmic fairness by arguing that in addition to ex-ante statistical modeling of probable harms, algorithmic fairness can be strengthened by ex-post analysis of the harms arising from algorithmic design, prioritizing the voices of people with lived experience using the algorithms that are designed to serve them, a key feature of harm reduction work within the opioid crisis (Drainoni et al, 2019). Ex-post analysis of algorithmic harms would ethnographically collect and prioritize the voices of people who have experienced the algorithm in question, especially the most marginalized and vulnerable including minorities, lowincome, and those with disability.…”