Courtesy stigma: a hidden health concern among front‐line service providers to sex workers

Abstract

Courtesy stigma, also referred to as 'stigma by association', involves public disapproval evoked as a consequence of associating with a stigmatised individual or group. While a small number of sociological studies have shown how courtesy stigma limits the social support and social opportunities available to family members of stigmatised individuals, there is a paucity of research examining courtesy stigma among the large network of people who provide health and social services to stigmatised groups. This article presents results from a mixed methods study of the workplace experiences of a purposive sample of workers in a nonprofit organisation providing services to sex workers in Canada. The findings demonstrate that courtesy stigma plays a role in workplace health as it shapes both the workplace environment, including the range of resources made available to staff to carry out their work activities, as well as staff perceptions of others' support. At the same time, it was evident that some workers were more vulnerable to courtesy stigma than others depending on their social location. We discuss these results in light of the existing literature on courtesy stigma and conclude that it is an under-studied determinant of workplace health among care providers serving socially denigrated groups.

Barriers and facilitators of linkage to HIV care among HIV-infected young Chinese men who have sex with men: a qualitative study

“…This perception has also been labeled as “courtesy stigma”, a type of stigma by association [16]. For this reason, some participants did not visit the CDC at all.…”

Cooperation, Trust, and Antagonism

“…In support of this argument is the fact that AIDS volunteers who had large social networks were found to be more likely to quit than were those who had small social networks, the assumption being that the AIDS volunteerism produces more fundamental disruption to social relations as the size of the network grows (Snyder & Omoto, 2000). A similar problem may also arise with volunteers who work with cancer patients (Remmer, Edgar, & Rapkin, 2001), the mentally ill (Sadow, Ryder, & Webster, 2002), or sex workers (Phillips, Benoit, Hallgrimsdottir, & Vallance, 2012). There is evidence that, once tainted, individuals will maintain the stigma even after they leave the volunteer role (see Bergman & Chalkley, 2007), and public health theorists have begun worrying that the stigmatization of volunteer helpers may arise with other infectious diseases that do not contain the risky-behavior subtext associated with AIDS-SARS, for example (Des Jarlais, Galea, Tracy, Tross, & Vlahov, 2006).…”

People-centred integration in a refugee primary care service

“…However, multidisciplinary services for marginalised persons face challenges meeting high health needs with limited resources, often under stress (Dollard et al, 2007). These stresses are amplified when working with marginalised populations that are stigmatised in the public and policy discourse (Phillips et al, 2012) measures that subsidise access to health care and pharmaceuticals (Phillips, 2014). Refugee and asylum seeker populations are subject to rapid changes, reflecting new and changing conflicts, and global flows of displaced people.…”