American journal of preventive medicine
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As patients become increasingly involved in healthcare decision-making, it is important to examine the drivers behind patient choice of doctor (PCOD); the initial decision can have lasting impacts on patients' trust in providers and health outcomes. However, limited studies have explored PCOD relative to socioeconomic status (SES) or health disparity. This review identified similar preferences and varied decision criteria in PCOD across SES groups. ⋯ Patients' decision criteria varied by SES, even under national systems intended for universal access, indicating the impacts of social determinants and structural inequities. Health education supporting patient decision-making and research on how SES affects PCOD and outcomes could help reduce health disparity.
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Pandemic-era social and political tensions may have accelerated pre-existing trends in gun owner diversification and shifts toward protection from people as a primary reason for gun ownership. Specific ownership motivations may shape storage behaviors, use patterns, policy support, and perceptions of safety. This study's objective was to assess the importance of specific reasons for owning guns, including protection from whom and in what circumstances, among demographic subgroups of new and prior gun owners. ⋯ Concurrent, strongly held motivations may produce ambivalence or resistance to public health messaging that narrowly focuses on preventing violent firearm-related injury. Permissive firearm policies may compound behavioral ambivalence, exacerbating conditions that threaten collective safety and civic expression. These conditions call for more nuanced, multidimensional, societal efforts to assure collective safety.
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Men who have sex with men (MSM) and are engaged in transactional sex (MSM-TS) experience complex social and structural vulnerabilities that increase their HIV risk. This study aimed to estimate the prevalence of TS and associations between TS and sexually transmitted infection (STI) outcomes among cisgender MSM in the U.S. ⋯ Structural and behavioral risks converged among U.S. MSM engaging in TS leading to greater HIV and bacterial STI prevalence in this group. HIV interventions for U.S. MSM-TS should address individual as well as structural risks, including poverty and housing instability.