Table 2.

A systematic review of quantitative studies investigating the intersection of gender and drug use stigma from the individual perspective (n = 13).

Individual Perspective of Stigma
#	Author (Year)	Study characteristics				Participant characteristics			Stigma-related variables	Summary of results	Quality Score
		n	Population	Location	Design	Age	Gender 4	Race/Ethnicity
28	Khuat (2015)	403	Women who inject drugs	Hanoi& Ho Chi Minh City, Vietnam	Cross-sectional survey design.	Hanoi Mean: 32.8 HCMC Mean 27.3	100% women	NR	Asked participants 3 questions about how they perceived society viewed WWID.	Over 80% of the sample agreed society viewed WWID to be worse than MWID and of “bad character.” Over half of the sample agreed society viewed female drug use as worse than sex work.	7
29	van Boekel (2016)	186	Individuals in treatment for substance use disorders.	The Netherlands	Cross-sectional survey design.	Mean: 40.9 Range: 16–70	31.2% women, 67.7% men.	NR	The Dutch version of the Discrimination and Stigma Scale (DISC-12) assessed experienced and anticipated stigma.	Gender did not significantly predict experienced or anticipated substance use stigma.	13
30	Rivera (2014)	132	People who inject drugs accessing syringe pharmacy	Manhattan/the Bronx, New York US)	Cross-sectional survey design.	Mean: 42.7	19.9% women, 80.1% men.	55.3% Lantinx, 31.1% White/Other, 13.6% Black	The Attitudes Towards Injection Drug Users Scale	Gender was not significantly related to PWID-related stigma scores.	13
31	Wilson (2014)	236	Needle and syringe program clients	Western Sydney, Australia	Cross-sectional survey design.	Mean: 39.0	34.3% women, 64.8% men, 0.8% trans gender	22% Aboriginal, 78% Non-Aboriginal	Five items assessing perceived discrimination from NSP staff/health care workers.	Perceived stigma and discrimination from general health workers was not correlated with gender or any injection outcome variables.	11
32	Crawford (2012)	647	Recently initiated people who inject drugs and PWUD (heroin, cocaine, crack)	New York City, NY (US)	Cross-sectional survey study.	Median: 33	29.5% women, 70.5% men.	48.8% Black, 37.1% Hispanic, 14.1% White/Other	Items assessing experiences of dis crimination for a variety of characteristics (including drug use)	No significant gender differences in drug use discrimination.	12
33	Luoma (2009)	252	Adults in treatment for substance use related problems.	United States	Cross-sectional survey design.	Mean: 30.5 Range: 18–63	42.1% women, 57.5% men.	7 % Caucasian, 12% Latinx, 7% Other, 4% African American, 4% Native American, 1% Asian/Pacific Islander	Perceived Stigma of Addiction Scale (PSAS) Internalized Shame Scale (ISS) Internalized Stigma of Substance Abuse (ISSA) Stigma-Related Rejection Scale (SRS) - Adapted for substance use.	Perceived stigma (PSAS scores) was not related to gender.	10
34	Semple (2007)	146	Heterosexual, HIV negative adult women who use meth.	San Diego, CA (US)	Cross-sectional survey design.	Mean: 35.4 Range: 18–56	100% women	45.2% Caucasian, 30.8% African American, 13.7% Latina, & 10.3% Other	Social stigma of meth use (14 items)	Women who had higher depressive symptoms had higher scores on social stigma of meth use.	12
35	Semple (2005)	292	Heterosexual adults who use meth.	san Diego, CA (US)	Cross-sectional survey design.	Mean: 37.8	27.7% women, 72.3% men.	54.8% Caucasian	Three stigma scales developed for the study: (1) Expectations of rejection, (2) Experiences of rejection, & (3) Stigma coping strategies.	Gender was not correlated with experiences or expectations of rejection.	11
36	Friedman (2016)	751	People who inject drugs, High-risk heterosexuals, & men who have sexwith men	New York (US)	Cross-sectional survey design.	PWID Mean: 40.9 HRH Mean: 32.6 MSM Mean: 25.6	PWID: 44% women, 56% men. HRH: 48% women, 52% men, (4 trans participants not in anlyses) MSM: 100% men	PWID: 54% Black, 57% Hispanic. HRH: 71% Black, 66% Hispanic. MSM: 56% Black, 54% Hispanic.	Five items assessing perceived attacks on participant dignity, witnessing dignity attacks on others, characteristics participants were attacked for, reactions to dignity attacks, and who committed the dignity attack.	1% of PWID reported their dignity being attacked due to their gender - though MSM were more likely to report this than PWID. Also, 41% of dignity attacks for PWID came from mothers. And mothers were more likely to be reported as sources of dignity attacks for PWID than HRH or MSM.	13
37	Cama (2016)	102	People who inject drugs accessing an NSP	Sydney, Australia	Cross-sectional survey design.	lean: 39.4	23% women, 75% men, 2% transgender	NR	Seven items from an adapted Internalized Stigma of Mental Illness (ISMI) Five items to assess perceptions of discriminatory treatment by staff at the NSP.	Gender was not correlated with internalized stigma.	11
38	Semple (2009)	402	Heterosexual adults who use meth	San Diego, CA (US)	Cross-sectional survey design.	Mean: 36.9 Range: 18–63	33% women, 67% men.	55% Caucasian, 29.9% African American, 15.1% Latinx	14 item social stigma scale comprised of two dimensions: (1) Culturally-induced expectations of rejection, and (2) experiences of rejection.	In ethnicity by gender analyses - no significant gender differences in rejection were found.	10
39	Palamar (2012)	700	Adults	United States	Internet-based survey design.	Mean: 29.3	69% women, 31% men.	67.1% White, 12.2% Hispanic, 9.1% Asian American, 7.3% Black, 4.3% Other	10-item Stigma of Drug Users Scale. Measures perceptions of public stigma towards users. Developed a pe ceiv d rejection anc secrecy scale: 2 %ctors - (1) perceived rejection and (2) secrecy (anticipated stigma)	Older and male PWUD reported greater perceived rejection for substance use. There were no gender differences in secrecy regarding substance use.	12
40	Heath (2016)	440	Adult PWID	Bangkok, Thailand	Cross sectional survey design.	Median: 38	19.5% women, 80.5% men.	NR	One item of health care avoidance: “Do you sometimes avoid accessing healthcare services because you are a drug user?”	There were no gender differences in health care avoidance.	13

^*NR = Not Reported.