Social and structural determinants of injecting-related bacterial and fungal infections among people who inject drugs: protocol for a mixed studies systematic review

IntroductionInjecting-related bacterial and fungal infections are a common complication among people who inject drugs (PWID), associated with significant morbidity and mortality. Invasive infections, including infective endocarditis, appear to be increasing in incidence. To date, preventive efforts have focused on modifying individual-level risk behaviours (eg, hand-washing and skin-cleaning) without much success in reducing the population-level impact of these infections. Learning from successes in HIV prevention, there may be great value in looking beyond individual-level risk behaviours to the social determinants of health. Specifically, the risk environment conceptual framework identifies how social, physical, economic and political environmental factors facilitate and constrain individual behaviour, and therefore influence health outcomes. Understanding the social and structural determinants of injecting-related bacterial and fungal infections could help to identify new targets for prevention efforts in the face of increasing incidence of severe disease.Methods and analysisThis is a protocol for a systematic review. We will review studies of PWID and investigate associations between risk factors (both individual-level and social/structural-level) and the incidence of hospitalisation or death due to injecting-related bacterial infections (skin and soft-tissue infections, bacteraemia, infective endocarditis, osteomyelitis, septic arthritis, epidural abscess and others). We will include quantitative, qualitative and mixed methods studies. Using directed content analysis, we will code risk factors for these infection-related outcomes according to their contributions to the risk environment in type (social, physical, economic or political) and level (microenvironmental or macroenvironmental). We will also code and present risk factors at each stage in the process of drug acquisition, preparation, injection, superficial infection care, severe infection care or hospitalisation, and outcomes after infection or hospital discharge.Ethics and disseminationAs an analysis of the published literature, no ethics approval is required. The findings will inform a research agenda to develop and implement social/structural interventions aimed at reducing the burden of disease.PROSPERO registration numberCRD42021231411.

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Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity (‘SNAP’) health risk factors

Preventive Medicine ◽

10.1016/j.ypmed.2015.07.003 ◽

2015 ◽

Vol 81 ◽

pp. 16-41 ◽

Cited By ~ 141

Author(s):

Natasha Noble ◽

Christine Paul ◽

Heidi Turon ◽

Christopher Oldmeadow

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Systematic Review ◽

Health Risk ◽

Risk Behaviours ◽

Health Risk Factors ◽

Health Risk Behaviours

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The social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews

Eastern Mediterranean Health Journal ◽

10.26719/emhj.20.101 ◽

2020 ◽

Author(s):

Dianne Egli Gany ◽

Wafa Aftab ◽

Sarah Hawkes ◽

Laith Abu Raddad ◽

Kent Buse ◽

...

Keyword(s):

Systematic Review ◽

Reproductive Health ◽

Sexual And Reproductive Health ◽

Structural Determinants ◽

The Social ◽

Review Of Reviews

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PROTOCOL: Organised crime groups: A systematic review of individual‐level risk factors related to recruitment

Campbell Systematic Reviews ◽

10.1002/cl2.1022 ◽

2019 ◽

Vol 15 (1-2) ◽

Author(s):

Francesco Calderoni ◽

Elisa Superchi ◽

Tommaso Comunale ◽

Gian Maria Campedelli ◽

Martina Marchesi ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Organised Crime ◽

Individual Level ◽

Organised Crime Groups

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From “Her” Problem to “Our” Problem: Using an Individual Lens Versus a Social-Structural Lens to Understand Gender Inequity in STEM

Industrial and Organizational Psychology ◽

10.1017/iop.2018.7 ◽

2018 ◽

Vol 11 (2) ◽

pp. 267-290 ◽

Cited By ~ 22

Author(s):

Kathi N. Miner ◽

Jessica M. Walker ◽

Mindy E. Bergman ◽

Vanessa A. Jean ◽

Adrienne Carter-Sowell ◽

...

Keyword(s):

Gender Equity ◽

Women In Science ◽

Gender Inequity ◽

Individual Level ◽

Representation Of Women ◽

Gender Parity ◽

The Social ◽

Social Structural ◽

Societal Level ◽

And Mathematics

Increasing the representation of women in science, technology, engineering, and mathematics (STEM) is one of our nation's most pressing imperatives. As such, there has been increased lay and scholarly attention given to understanding the causes of women's underrepresentation in such fields. These explanations tend to fall into two main groupings: individual-level (i.e., her) explanations and social-structural (i.e., our) explanations. These two perspectives offer different lenses for illuminating the causes of gender inequity in STEM and point to different mechanisms by which to gain gender parity in STEM fields. In this article, we describe these two lenses and provide three examples of how each lens may differentially explain gender inequity in STEM. We argue that the social-structural lens provides a clearer picture of the causes of gender inequity in STEM, including how gaining gender equity in STEM may best be achieved. We then make a call to industrial/organizational psychologists to take a lead in addressing the societal-level causes of gender inequality in STEM.

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Prevalence and high risk behaviours associated with HCV testing among people who inject drugs: a systematic review and Meta-analysis

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-020-00306-1 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Salah Eddin Karimi ◽

Azadeh Bayani ◽

Peter Higgs ◽

Amir-Hossein Bayat ◽

Morteza Hemmat ◽

...

Keyword(s):

Systematic Review ◽

High Risk ◽

People Who Inject Drugs ◽

Meta Analysis ◽

Risk Behaviours ◽

Hcv Testing

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Syringe Sharing and the Risk of Viral Transmission Among People Who Inject Drugs in Nigeria: Structural, Relational, and Subjective Influences on Behaviors

Journal of Drug Issues ◽

10.1177/0022042618811654 ◽

2018 ◽

Vol 49 (2) ◽

pp. 387-404 ◽

Cited By ~ 6

Author(s):

Ediomo-Ubong E. Nelson ◽

Gboyega E. Abikoye

Keyword(s):

Risk Reduction ◽

Management Practices ◽

People Who Inject Drugs ◽

Structured Interview ◽

Viral Transmission ◽

Oral Drug ◽

Snowball Sampling ◽

Policy Reforms ◽

Risk Environment ◽

Structural Determinants

In this article, we report findings of a qualitative study on structural, relational, and subjective determinants of injecting risks. Forty-one current people who inject drugs (PWIDs) were recruited through snowball sampling in Uyo, Nigeria. They were interviewed with a loosely structured interview guide. We employed inductive and thematic analysis of interview transcripts. PWIDs recognize the risk of viral transmission through sharing of syringes. As countermeasures, they inject with sterile syringes, refuse to borrow syringes, and disinfect borrowed syringes. Risk reduction efforts are undermined by withdrawal, pleasure seeking, public injecting settings, policing, social networks, and intimate relationships. These factors create a risk environment for viral transmission. Pleasure-seeking and risk reduction practices show agency and subjectivity, counterbalancing current emphasis on structural determinants of injecting risks. Findings indicate the need for policy reforms, needle and syringe provision, oral drug substitution, safe injecting environments, and peer education. Interventions should build on PWIDs’ agency and risk management practices.

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The Social Structural Determinants of Ethnic Group Behavior: Single Ancestry Rates Among Four White American Ethnic Groups

American Sociological Review ◽

10.2307/2095856 ◽

1988 ◽

Vol 53 (4) ◽

pp. 650 ◽

Cited By ~ 6

Author(s):

Barbara Tomaskovic-Devey ◽

Donald Tomaskovic-Devey

Keyword(s):

Ethnic Group ◽

Ethnic Groups ◽

Group Behavior ◽

Structural Determinants ◽

White American ◽

The Social ◽

Social Structural

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Ultra-Processed Food Availability and Noncommunicable Diseases: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147382 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7382

Author(s):

Taissa Pereira de Araújo ◽

Milena M. de Moraes ◽

Vânia Magalhães ◽

Cláudia Afonso ◽

Cristina Santos ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Health Outcomes ◽

Food Consumption ◽

Selection Process ◽

Positive Association ◽

Overweight And Obesity ◽

Noncommunicable Diseases ◽

Processed Food ◽

Individual Level

Ultra-processed food (UPF) can be harmful to the population’s health. To establish associations between UPF and health outcomes, food consumption can be assessed using availability data, such as purchase lists or household budget surveys. The aim of this systematic review was to search studies that related UPF availability with noncommunicable diseases or their risk factors. PRISMA guidelines were used. Searches were performed in PubMed, EBSCO, Scopus and Web of Science in February 2021. The search strategy included terms related to exposure (UPF) and outcomes (noncommunicable diseases and their risk factors). Studies that assessed only food consumption at an individual level and did not present health outcomes were excluded. Two reviewers conducted the selection process, and a third helped when disagreement occurred. The Newcastle–Ottawa Scale was used to assess the studies’ quality; 998 records were analyzed. All 11 eligible studies were ecological and assessed overweight and obesity as a health outcome, only one showed no positive association with UPF availability. Two studies included the prevalence of diabetes as an outcome, however no significant association was found with UPF availability. Studies relating UPF availability and health outcomes are focused on overweight and obesity. It is necessary to further explore the relationship between other health outcomes and UPF availability using purchase or sales data.

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