Drivers, Facilitators, and Sources of Stigma Among Akha and Lahu Hill Tribe People who used Methamphetamine in Thailand: A Qualitative Approach

Background: The stigma related to drug use has several impacts, including effects on users’ physical and mental health. Methamphetamine is the major drug that is used among hill tribes living in the border areas of Thailand and Myanmar. This study aimed to understand the drivers, facilitators, sources and outcomes of the stigma surrounding drug use, including the expectations among Akha and Lau hill tribe people who use methamphetamine in Thailand. Methods: : Qualitative data were used to elicit information from the key informants, members of the hill tribes who used methamphetamine. Questions guild was developed from a literature review and tested for validity before use. In-depth interviews were used to gather information confidentially from the participants in private rooms in villages. Each interview lasted 45 minute, and a thematic analysis was conducted to examine the findings. Results: : A total of 46 participants were recruited to provide information; 95.7% were male, and 50.0% were aged between 15-34 years. The majority were married (47.8%), 76.1% were Christian, and 45.7% graduated high school. Six drivers of stigma were detected, being: poor, illiterate, unemployed, working age, female sex, and marital status. Culture and tribe acted as facilitators of the stigma attached to methamphetamine use. Four sources of stigma were found: self, family members, peers, and community members. Three outcomes stigma were determined, poor: physical health, mental health, and relationships with others. There were four levels of expectations: no expectations, expectations for themselves, expectations for their family members, and expectations for their community members. Conclusions: : Many personal traits, people living nearby, and socioeconomic factors, including culture and tribes, act as drivers, facilitators, and sources of stigma among hill tribe people who use methamphetamine. A program to reduce methamphetamine use among hill tribes should be implemented, which could eventually minimize stigma.