Evidence map›Paper›PMID 35668408›Full record

ArticleBMC health services research2022

"Syndemic moral distress": sexual health provider practices in the context of co-occurring, socially produced sexual and mental health epidemics.

Travis Salway, Stéphanie Black, Angel Kennedy, Sarah Watt, Olivier Ferlatte, Mark Gaspar, Rod Knight, Mark Gilbert

Abstract read
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. A Contextualization of Transgender Women and Condom Use Using the HIV Syndemic Framework: Scoping Review.International journal of sexual health : official journal of the World Association for Sexual Health · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Travis SalwayFaculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A1S6, Canada. travis_salway@sfu.ca.
Stéphanie BlackFaculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A1S6, Canada.
Angel KennedyFaculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A1S6, Canada.
Sarah WattFaculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A1S6, Canada.
Olivier FerlatteÉcole de Santé Publique de L'Université de Montréal, 7101 Avenue du Parc, Montréal, Québec, H3N1X9, Canada.
Mark GasparDalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T3M7, Canada.
Rod KnightBC Centre On Substance Use, 1045 Howe Street, Suite 400, Vancouver, BC, V6Z2A9, Canada.
Mark GilbertBC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z4R4, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background'Syndemic' refers to socially produced, intertwined, and co-occurring epidemics. Syndemic theory is increasingly used to understand the population-level relationships between sexual health (including HIV) and mental health (including problematic substance use) epidemics. Syndemic-informed clinical interventions are rare.

methodsWe therefore asked 22 sexual health practitioners from six sexual health clinics in British Columbia, Canada to define the word 'syndemic' and then asked how the theory related to their clinical practice.

resultsResponses to syndemic theory ranged widely, with some practitioners providing nuanced and clinically informed definitions, others expressing a vague familiarity with the term, and others still having no prior knowledge of it. Where practitioners acknowledged the relevance of syndemic theory to their practice, they articulated specific ways in which syndemics create moral distress, that is, feeling that the most ethical course of action is different from what they are mandated to do. While some practitioners routinely used open-ended questions to understand the social and economic contexts of patients' sexual health needs, they described an uneasiness at potentially having surfaced concerns that could not be addressed in the sexual health clinic. Many observed persistent social, mental health, and substance use-related needs among their patients, but were unable to find feasible solutions to these issues.

conclusionsWe therefore propose that interventions are needed to support sexual health practitioners in addressing psychosocial health needs that extend beyond their scope of practice, thereby reducing 'syndemic moral distress'.

Indexed as

EpidemicsHIV InfectionsSexual HealthSubstance-Related DisordersBritish ColumbiaHumansMental HealthMoralsSexual BehaviorSyndemicHIVMental healthMoral distressSexual healthSyndemic theory

Identifiers

PMID35668408
PMCPMC9169335

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.