Table 1

Aims 1 and 2 constructs and measurement tools

Aim 1. Provider-reported
Quantitative
Provider attitudes

  • Drug Problems Perceptions Questionnaire56

  • Healthcare Provider HIV/AIDS Stigma Scale57

  • Racism in Healthcare Index58

Acceptance of HR

  • Harm Reduction Acceptability Scale59 60

Structural HR

  • Organisational Survey of Structural HR

Structural HR

  • Provider Survey of Structural HR

Qualitative
Interviews

  • Contextualise survey results (n=40)

Aim 2. Provider-reported
Qualitative
Interviews

  • Evaluate PAPHRS (n=20)

Aim 2. Patient-reported (PWH who use drugs)
Qualitative
Focus groups

  • Evaluate PAPHRS (n=36)

Quantitative
Experiences of stigma and discrimination in healthcare settings

  • Enacted HIV Stigma from Health Facility Staff20 61

  • Substance Use Stigma Mechanisms Scale (Enacted Stigma from Healthcare Workers subscale)62

  • Interpersonal Processes of Care Survey (Discrimination Due to Race/Ethnicity subscale)63

Patient–provider relationship

  • Attitudes Toward HIV Healthcare Providers Scale64

  • Single-item from Beach et al: ‘My provider knows me as a person.’65

Receipt of structural HR care

  • Patient Survey of Structural HR66

Receipt of relational HR care

  • 25-item PAPHRS

Patient clinical outcomes (EHR data)

  • HIV viral load (<200 copies/mL, virally suppressed)

  • Retention in HIV primary care (two visits at least 90 days apart within 1 year; proportion of missed to scheduled visits)

  • Self-reported ART adherence—CASE Index

  • HCV viral load

  • Retention in MOUD and/or in behavioural health treatment for diagnosis of substance use disorder (proportion of kept to scheduled visits)

Qualitative
Focus groups

  • Assess experiences of intersectional stigma (n=36)

  • ART, antiretroviral therapy; HR, harm reduction; MOUD, medications for opioid use disorder; PAPHRS, Patient Assessment of Provider Harm Reduction Scale; PWH, people with HIV.