People who inject drugs carry a disproportionate burden of disease related to HIV and hepatitis C virus (HCV) infection, and therefore, represent a key target group in prevention efforts and in the global agenda to eliminate these infections by 2030, led by the World Health Organisation. In many settings, including the UK, people who inject drugs also experience a high rate of overdose. So far, HCV, HIV and overdose prevention strategies have primarily targeted opioid use and the public health response to problem drug use has focused on specific drug classes in isolation[1,2] which may not adequately address the broader multi-faceted problem of polydrug use[3]. Indeed, several studies suggest that polydrug use (i.e, the use of ≥2 different substances either simultaneously or separately over a defined period of time) is frequent among people who inject drugs, and is associated with greater injecting and sexual practices, and risk of HIV, HCV and overdose[4,5]. There is a pressing need to synthesise the body of work conducted so far and to conduct new research—particularly outside the North American context—to build a coherent picture of the extent and patterns of polydrug use and its harms in people who inject drugs.
Aims and objectives
The specific aims (SA) are to:
SA1: Systematically review and synthesise the evidence on the extent of polydrug use among people who inject drugs globally, and its impact on risk practices and risk of HIV and HCV infection and overdose
SA2: In settings where polydrug use has been understudied, use context-specific data to assess its impact on HIV, HCV and overdose
SA3: Through epidemic modelling, determine the importance of developing interventions that minimise polydrug use-related risks among people who inject drugs for achieving HIV and HCV elimination and reducing overdose in different global settings
Methodology
Although the student will be encouraged to pursue a range of methodological skills, the proposal and our research program is flexible and accommodating of individual interests. For example, the student will have the option to focus their training on specific methodologies associated with each of the three aims: systematic reviews/evidence synthesis (SA1), epidemiological analyses (SA2) and epidemic modelling (SA3). During the first few weeks, we will complete a training needs assessment to identify areas of interest, skill strengths, skills that need to be developed, and opportunities for development over the course of the PhD training. Our team is comprised of senior and early-career researchers with distinct expertise in quantitative methodologies and skills in data analysis and modelling[6-8], and so the student will integrate a rich, stimulating and highly supportive learning environment. We also have several collaborations nationally and internationally and links with international agencies (WHO, EMCDDA), thereby ensuring that the research outputs have implications on a global scale, are timely, and can inform public health policy. Overall, the project and learning environment will support the student in developing a well-rounded skillset in epidemiology and epidemic modelling applicable to the study of other diseases and research sectors.
How to apply for this project
This project will be based in Bristol Medical School - Population Health Sciences in the Faculty of Health Sciences at the University of Bristol.
Please visit the Faculty of Health Sciences website for details of how to apply
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