One of the key drivers of antibiotic resistance (ABR) and drug-resistant bacterial infections is the misuse and overuse of antibiotics in human populations. Infection management and antibiotic decision-making are multifactorial, complex processes influenced by context and involving many actors. Social constructs including race, ethnicity, gender identity and cultural and religious practices as well as migration status and geography influence health. Infection and ABR are also affected by these external drivers in individuals and populations leading to stratified health outcomes. These drivers compromise the capacity and resources of healthcare services already over-burdened with drug-resistant infections. In this review we consider the current evidence and call for a need to broaden the study of culture and power dynamics in healthcare through investigation of relative power, hierarchies and sociocultural constructs including structures, race, caste, social class and gender identity as predictors of health-providing and health-seeking behaviours. This approach will facilitate a more sustainable means of addressing the threat of ABR and identify vulnerable groups ensuring greater inclusivity in decision-making. At an individual level, investigating how social constructs and gender hierarchies impact clinical team interactions, communication and decision-making in infection management and the role of the patient and carers will support better engagement to optimize behaviours. How people of different race, class and gender identity seek, experience and provide healthcare for bacterial infections and use antibiotics needs to be better understood in order to facilitate inclusivity of marginalized groups in decision-making and policy.
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http://dx.doi.org/10.1093/jacamr/dlab123 | DOI Listing |
Arch Dis Child
January 2025
Department of Sociology, University of York, York, UK
Background: Gender identity services for children and young people are currently being reorganised in England and Wales. Provision is required to negotiate clinical uncertainty and a public debate that cannot agree on what care should look like.
Objectives: To explore how young people, parents and young adults respond to gender dysphoria, distress or discomfort; and to understand how they negotiate referral, assessment and possible interventions.
Proc Natl Acad Sci U S A
February 2025
Department of Psychology, Princeton University, Princeton, NJ 08540.
Traditional gendered arrangements-norms, roles, prejudices, and hierarchies-shape every human life. Associated harms are primarily framed as women's issues due to more severe consequences women face. Yet, gendered arrangements also shape 's relationships, career paths, and health.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
San Francisco Department of Public Health, San Francisco, California.
Importance: The rise of high-potency opioids such as fentanyl makes buprenorphine initiation challenging due to the risks of precipitated withdrawal, prompting the exploration of strategies, such as low-dose initiation (LDI) of buprenorphine. However, no comparative studies on LDI outcomes exist.
Objective: To evaluate outpatient outcomes associated with 2 LDI protocols of buprenorphine among individuals with opioid use disorder (OUD) using fentanyl.
AIDS Behav
January 2025
Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
Healthy aging is an important area of research across many populations, but less work has focused on this area among sexual and gender diverse individuals relative to the general population. On the whole, it is known that as the U.S.
View Article and Find Full Text PDFArch Sex Behav
January 2025
Department of Psychology, Michigan State University, 316 Physics Rd., East Lansing, MI, 48824, USA.
The visibility and number of people identifying as asexual-those with little to no sexual attraction-have been increasing in recent years. In the current study, we examined variation in experiential and developmental milestones and psychosocial functioning in 1,726 individuals on the asexual spectrum (61.2% women, 15.
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