Search results

Global evidence indicates that multiple structural, biological, and behavioural mechanisms link gender-based violence (GBV), HIV/HCV, and substance misuse among women and adolescent girls. The aim of this chapter is to briefly summarise and synthesise recent literature that examines the complex and bi-directional relationships among these epidemics in different populations of adolescent girls and women around the world. To inform this chapter, a selective search strategy was conducted, prioritising use of meta-analytic epidemiological studies and research on interventions and policies that address different aspects of the syndemic among women and girls who use drugs worldwide. The search targeted publications from 2015 to 2019 using PubMed, MEDLINE, and Google Scholar. The chapter highlights methodological and geographic gaps in existing policy, intervention, and implementation research and makes recommendations for strategies to tackle these gaps. It also identifies a continuum of multilevel evidence-based interventions that target the risk environments and key syndemic mechanisms linking these intersecting epidemics that have been found to be effective in reducing intimate partner violence and other forms of GBV, substance use, and HIV/HCV risks. This chapter also assesses inclusiveness of existing research and interventions for underserved and disproportionately affected populations, affecting adolescent girls, sexual minority women, and racial/ethnic minority women and identifies strategies to target gaps or disparities for these key affected populations. Finally, this chapter describes the gaps and opportunities that harm reduction programmes, medical settings, and other community organisations experience in implementing gender-responsive programmes and policies to redress these intersecting epidemics.

People who inject drugs (PWID) face multiple health problems, including infectious diseases and drug overdoses. Applying syndemic and risk environment frameworks, this paper aims to examine the co-occurrence and clustering of drug-related harms and their association with incarceration experience with or without in-prison drug injection.

The authors used data from a cross-sectional survey conducted in 2015 among 557 active opioid injectors. Self-reported data were collected through face-to-face or online questionnaires. They distinguished three harm categories, namely, viral infections, bacterial infections and overdoses, and built an index variable by summing the number of harm categories experienced, yielding a score from 0 to 3. Association between incarceration experience and co-occurrence of harms was modelled using a multinomial logistic regression.

Of the 557 participants, 30% reported lifetime experience of drug-related viral infection, 46% bacterial infection and 22% drug overdose. Multinomial logistic models showed that those who injected drugs during incarceration were more likely to report two (aOR = 2.35, 95% CI: 1.03–5.36) and three (aOR = 9.72, 95% CI: 3.23–29.22) harm categories than those who had never been incarcerated. They were also more likely to report three harm categories than formerly incarcerated respondents who did not inject drugs in prison (aOR = 5.14, 95% CI: 1.71–15.48).

This study provides insights of the syndemic nature of drug-related harms and highlights that drug injection during incarceration is associated with co-occurring harms. Public health interventions and policy changes are needed to limit the deleterious impact of prison on PWID.

This essay explores how women scholars grapple with gender and racial inequality during a syndemic. Using a culturally comparative lens, two mother-scholars, one Afro-Boricua who identifies as Black and the other Thai who identifies as Asian, examine this topic through a comparative international womanist theoretical framework. This discussion provides a brief overview of the challenges faculty women of color have faced around the world in contemporary history. It also interrogates how the professional identities of these scholars inform their teaching, scholarship, and personal lives during a period fraught with anti-Blackness and anti-Asian hostility, gender bias, familial demands, and heightened fear and isolation. Through counter-narratives, their lived experiences are placed into a global context and insightful comparisons spotlight specific challenges that uniquely converge for women of color in the academy. This analytical discussion reflects trends in the field of comparative education by examining the impact of gender and racial discrimination on women scholars of color within political, economic, social, and cultural landscapes.

The purpose of this paper is to consider the potential of public health perspectives to “come to the aid” of dementia research and practice.

This paper draws on research and policy papers.

This paper outlines some potential preventive interventions, focussing particularly on life-course phenomena like child poverty, diet and pollution, on the biological mechanisms that enable psychosocial interventions, and on the status of dementia as a syndemic disorder.

This paper presents the opinions of the authors alone. It is based on recent research evidence and the authors’ experiences of dementia research, education and services. The implications for social scientists and for dementia research funders are contained in discussion of the need for research on prevention and social support for people with dementia and their families. While the evidence to guide primary prevention using psychosocial methods is less secure, the paper outlines a large secondary prevention research agenda in dementia.

Methodological approaches that facilitate harmonisation, pooling and comparison of data, are needed. In practical terms the paper argues that there is a need to know if and how psychosocial interventions work, and improve quality of life or even influence harder outcomes.

Few papers have considered the implications of a public health approach to dementia other than taking an epidemiological approach and focusing on the problems of dementia and rising numbers. This paper argues that a wider view of public health may be of particular relevance to dementia syndrome.

The purpose of this paper is to discover and describe salient repeating and less common features of the recent medical literature about youth violence as it relates to mental health. How the relationship between youth violence and mental health is commonly conceptualized, investigated, and reported is summarized. Negative cases, unique approaches, and concepts are discussed.

An Ovid Medline literature search was conducted with the search parameters of “adolescent and violence” and “psychiatry or psychology or mental health.” In total, 66 articles met inclusion criteria and were analyzed using grounded theory procedures and techniques.

In all, 49 articles were reports of original research, 14 were literature reviews, and three were editorials. The articles included discussions of youth violence and mental health among young people in 49 countries. Most original research used cross-sectional designs that tested and supported the core hypothesis that greater exposure to violence is associated with more mental health issues. The relationship is robust even though characterizations of “exposure to violence” and “mental health” were highly variable. Meta-analytic and intervention studies were rare.

The core feature of the last decade of medical research has been the repeated testing and confirmation that a relationship between exposure to violence and mental health exists. Future youth violence research should move beyond continuing to test this hypothesis with cross-sectional study designs.

The lived experience of HIV+ Black MSM (men who have sex with men) in the South exposes persistent racialized inequality. With the highest rates of HIV diagnosis in the country, Black MSM are made to feel unequal within the US LGBTQ community, thereby perpetuating long-standing inequalities between the groups. We argue that Whites' and Blacks' differing conceptions of racial equality serve to limit the extent to which comprehensive LGBTQ equality is possible as whiteness frames the LGBTQ experience in the United States. Examining how the country's racist story of nonaccess, representation, and exclusion has stymied coalition building to eliminate inequalities, findings reveal the structural impediments toward racial parity. Utilizing the case study of HIV+ Black MSM in the South, we examine the persistence of inequality amid the thrice interwoven intramarginalization of feeling excluded from sociopolitical spaces, having limited political representation, and engaging with racist body politics.

Little is known about the context of the post-release risk environment among formerly incarcerated people who inject drugs (PWID) in Russia. The purpose of this paper is to explore these challenges as they relate to reentry, relapse to injection opioid use, and overdose.

The authors conducted 25 in-depth semi-structured interviews among PWID living in St Petersburg, Russia who had been incarcerated within the past two years. Participants were recruited from street outreach (n=20) and a drug treatment center (n=5).

Emergent themes related to the post-release environment included financial instability, negative interactions with police, return to a drug using community, and reuniting with drug using peers. Many respondents relapsed to opioid use immediately after release. Those whose relapse occurred weeks or months after their release expressed more motivation to resist. Alcohol or stimulant use often preceded the opioid relapse episode. Among those who overdosed, alcohol use was often reported prior to overdosing on opioids.

Future post-release interventions in Russia should effectively link PWID to social, medical, and harm reduction services. Particular attention should be focussed on helping former inmates find employment and overdose prevention training prior to leaving prison that should also cover the heightened risk of concomitant alcohol use.

In addition to describing a syndemic involving the intersection of incarceration, injection drug use, poverty, and alcohol abuse, the findings can inform future interventions to address these interrelated public health challenges within the Russian setting.

The purpose of this paper is to clarify the origins, use and meaning of the term “chemsex”.

The approach used here is one born of personal experiences and reflection.

The term chemsex has a definition and a purpose that promotes culturally competent care for a marginalized group of vulnerable people.

This is a qualitative, personal, point-of-view piece which may be of value in broadening understandings and responses amongst public health and academic activities.

The findings can be used to develop a sense of community and support amongst men who have sex with men in a chemsex setting, and to provide some background and context for professionals working in this field.

This paper is amongst the first, if not the first, of its nature to be published in an academic journal.