{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:41:33Z","timestamp":1774460493505,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Patient-Centered Outcomes Research Institute (PCORI) Award","award":["HPC-1503-28122"],"award-info":[{"award-number":["HPC-1503-28122"]}]},{"DOI":"10.13039\/100015627","name":"Quest Diagnostics","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015627","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Monogram Biosciences"},{"name":"Gilead Sciences"},{"name":"OraSure Technologies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Personal protective measures help prevent infection and disease transmission during health crises such as Coronavirus disease 2019 (COVID-19). Populations facing barriers to adhering to these measures are more vulnerable to the health crisis. This study investigated the association of social drivers of health (SDoH), self-efficacy, and adverse substance use behavior changes with ability to practice COVID-19 personal protective behaviors among persons who inject drugs (PWID) with hepatitis C virus (HCV) infection history. Methods: This study used the Hepatitis C Real Options (HERO) study\u2019s COVID-19 survey data (n = 157). The association of inability to practice COVID-19 personal protective behaviors (hand washing, social distancing, etc.) with (a) SDoH difficulties (employment, housing, etc.); (b) adverse substance use behavior change (overdose, injecting behavior, etc.); and (c) self-efficacy was tested using logistic regression. Results: Inability to practice any personal protective behaviors was more likely among those experiencing any vs. no SDoH difficulties [adjusted odds ratio (aOR) (95% confidence interval (CI))] = 4.57 (1.57, 16.40); p = 0.003] but less likely for those with higher overall self-efficacy [aOR (95% CI) = 0.55 (0.32, 0.93); p = 0.025] and self-efficacy for setting goals [aOR (95% CI) = 0.63 (0.40, 0.96); p = 0.031]. The association between adverse substance use behavior changes and the outcome was not significant. Conclusions: Greater SDoH difficulties and lower self-efficacy were associated with greater inability to practice COVID-19 personal protective behaviors. Interventions to meet SDoH-related challenges and increase self-efficacy could help encourage practice of personal protective behaviors and economically reduce disease burden during health crises.<\/jats:p>","DOI":"10.3390\/ijerph23010093","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T16:03:16Z","timestamp":1767974596000},"page":"93","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Social Drivers of Health, Self-Efficacy, and Substance Use on COVID-19 Preventative Behaviors Among Persons Who Inject Drugs with Hepatitis C: The HERO Study"],"prefix":"10.3390","volume":"23","author":[{"given":"Snehal S.","family":"Lopes","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5814-0397","authenticated-orcid":false,"given":"Irene","family":"Pericot-Valverde","sequence":"additional","affiliation":[{"name":"Department of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0833-8642","authenticated-orcid":false,"given":"Paula J.","family":"Lum","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA 94110, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0472-8125","authenticated-orcid":false,"given":"Lynn E.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Clinical Research, University of Rhode Island, 7 Greenhouse Road, Kingston, RI 02881, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shruti H.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6546, Baltimore, MD 21205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-5399","authenticated-orcid":false,"given":"Judith I.","family":"Tsui","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, 325 9th Ave., Seattle, WA 98104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Feinberg","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV 26505, USA"},{"name":"Division of Infectious Diseases, Department of Medicine, West Virginia University School of Medicine, 1 Medical Center Drive, Morgantown, WV 26506, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur Y.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA"},{"name":"Harvard Medical School, Harvard University, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brianna L.","family":"Norton","sequence":"additional","affiliation":[{"name":"Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA"},{"name":"Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Page","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine MSC 10 5550, University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5488-1080","authenticated-orcid":false,"given":"Cristina","family":"Murray-Krezan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1346-6059","authenticated-orcid":false,"given":"Jessica","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine MSC 10 5550, University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Karasz","sequence":"additional","affiliation":[{"name":"UMass Chan Medical School, University of Massachusetts Medical School, 55 Lake Ave, North Worcester, MA 01605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7741-1567","authenticated-orcid":false,"given":"Julia","family":"Arnsten","sequence":"additional","affiliation":[{"name":"Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA"},{"name":"Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip","family":"Moschella","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Prisma Health, Greenville, SC 29605, USA"},{"name":"School of Health Research, Clemson University, Clemson, SC 29634, USA"},{"name":"Department of Medicine, University of South Carolina School of Medicine, 876 W Faris Rd, Greenville, SC 29605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7711-1209","authenticated-orcid":false,"given":"Moonseong","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain H.","family":"Litwin","sequence":"additional","affiliation":[{"name":"School of Health Research, Clemson University, Clemson, SC 29634, USA"},{"name":"Department of Medicine, University of South Carolina School of Medicine, 876 W Faris Rd, Greenville, SC 29605, USA"},{"name":"Department of Medicine, Prisma Health, Greenville, SC 29605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the HERO Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S1473-3099(20)30501-6","article-title":"Global shortage of personal protective equipment","volume":"20","author":"Burki","year":"2020","journal-title":"Lancet Infect. 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