Journal of urban health : bulletin of the New York Academy of Medicine
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The use of pre-exposure prophylaxis (PrEP) for HIV prevention within the U. S. military is low. Implementing preference-based alternative modalities of PrEP delivery, however, can be an innovative strategy to address the specific barriers to PrEP uptake among military MSM. ⋯ Simulations revealed that PrEP program interest among two segments with low interest levels increased when smartphone, civilian-based, and long-acting injectable PrEP options were involved. Findings also suggested a need for clinics to be responsive and sensitive to sexual practices, risk perception, and functional PrEP knowledge. Responsiveness to segment-specific preferences in the design of military PrEP programs and acting on the importance of clinical relationships within the context of PrEP engagement within a military setting may contribute to increasing PrEP uptake.
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Rollouts of COVID-19 vaccines in the USA were opportunities to redress disparities that surfaced during the pandemic. Initial eligibility criteria, however, neglected geographic, racial/ethnic, and socioeconomic considerations. Marginalized populations may have faced barriers to then-scarce vaccines, reinforcing disparities. ⋯ Increases in vaccination were smaller in socioeconomically disadvantaged Black and Hispanic communities than in more affluent, Asian, and White communities. Our findings suggest vaccine rollouts contributed to cumulative disadvantage. Populations that were left most vulnerable to COVID-19 benefited least from early expansions in vaccine availability in large US cities.
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Pedal cycling is advocated for increasing physical activity and promoting health and wellbeing. However, whilst some countries have achieved zero cyclist deaths on their roads, this is not the case for Great Britain (GB). A retrospective cross-sectional analysis was conducted of STATS19 cyclist crash data, a dataset of all police-reported traffic crashes in GB. ⋯ Sixteen thousand one hundred seventy pedal cycle crashes were reported during 2018. Severe or fatal cyclist crash injury was associated with increasing age of the cyclist (35-39 years, OR 1.38, 95% CI 1.11 to 1.73; 55-59 years, OR 1.73, 95% CI 1.35 to 2.2; 70 years and over, OR 2.87, 95% CI 2.12 to 3.87), higher road speed limits (50 MPH OR 2.10, 95% CI 1.43 to 3.07; 70 MPH OR 4.12, 95% CI 2.12 to 8.03), the involvement of goods vehicles (OR 2.08, 95% CI 1.30 to 3.33) and the months of May and June (OR 1.34 to 1.36, 95% CI 1.06 to 1.73). Urban planning that includes physical separation of pedal cyclists from other road users, raising awareness around the risks from goods vehicles and reducing road speed should be the urgent focus of interventions to increase the benefits and safety of cycling.
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Substance use during sexual encounters (sexualized substance use) is an important driver of HIV and sexually transmitted infection (STI) disparities that are experienced by men who have sex with men (MSM). This analysis aimed to identify patterns of sexualized substance use and their associations with HIV risk behaviors. We utilized visit-level data from a longitudinal cohort of predominantly Black/Latinx MSM, half with HIV and half with substance use in Los Angeles, California. ⋯ Compared to the no sexualized substance use class, sexualized stimulant use was associated with transactional sex, current diagnosis of STIs, not using HIV biomedical prevention, and depressive symptoms. Sexualized alcohol use had fewer associations with HIV risk behaviors. Patterns of sexual activities, and the substances that are used during those activities, confer different risk behavior profiles for HIV/STI transmission and demonstrate the potential utility of interventions that combine substance use treatment with HIV prevention.
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Although shrinking neighbourhoods are places where urban citizens experience negative emotions, some evidence suggests that people in some shrinking neighbourhoods feel less negative emotions than in other areas. Nevertheless, empirical studies that analyse environmental and personal elements that affect people's emotions in a shrinking neighbourhood remain insufficient. This is rather surprising, considering an increasing interest in the effects of negative emotions on individuals' health. ⋯ The results also found that people who had lived or worked in the neighbourhood for a long time and were women experienced more positive emotions than visitors and men. This finding implies that a shrinking neighbourhood can maintain a sense of satisfaction as long as the area is carefully managed. Revealing the emotional effects of environmental and personal characteristics in a shrinking neighbourhood can be used for planning practices and policy-making to create healthy and liveable urban neighbourhoods.