Journal of urban health : bulletin of the New York Academy of Medicine
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The study investigated pleasure-related, partner-related, and social normative correlates of recent condom refusal in young Black men (YBM). A cross-sectional study of YBM (N = 561) attending clinics treating sexually transmitted diseases in three cities was conducted. ⋯ Significant findings included the following: partner-related beliefs "I feel closer to my partner without a condom" (OR = 2.52, 95 % confidence interval (CI) = 1.65-3.83) and "condoms make sex hurt for the female partner" (OR = 1.69, 95 % CI = 1.14-2.52), a scale measure of pleasure-related beliefs (OR = 2.58, 95 % CI = 1.73-3.84), and a scale measure of negative social beliefs associated with condom usage (OR = 1.05, 95 % CI = 1.00-1.10). Interventions addressing pleasure-related, partner-related, and social normative beliefs as barriers to condom use are warranted for YBM.
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Exposure to environmental noise from traffic is common in urban areas and has been linked to increased risks of adverse health effects including cardiovascular disease. Because traffic sources also produce air pollutants that increase the risk of cardiovascular morbidity, associations between traffic exposures and health outcomes may involve confounding and/or synergisms between air pollution and noise. While prior studies have characterized intraurban spatial variation in air pollution in New York City (NYC), limited data exists on the levels and spatial variation in noise levels. ⋯ The high levels of noise observed in NYC often exceed recommended guidelines for outdoor and personal exposures, suggesting unhealthy levels in many locations. Associations between noise, traffic, and combustion air pollutants suggest the possibility for confounding and/or synergism in intraurban epidemiological studies of traffic-related health effects. The different spatial pattern of intermittent noise compared to average noise level may suggest different sources.
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We assessed awareness and use of the "NYC Condom" among persons who use heroin and cocaine in New York City. The NYC Condom distribution program is the largest free condom distribution program in the USA, with over 30 million condoms distributed per year. It includes a condom social marketing program for a specific brand, the NYC Condom with its own packaging and advertising. ⋯ In terms of market share, 38 % of subjects consistently using condoms with primary partners were using the NYC Condom, and 47 % of those consistently using condoms with casual partners were using the NYC Condom. The NYC Condom is an important tool for reducing sexual transmission of HIV and STI among persons who use drugs in the city. Given the strong relationship between using the NYC Condom and consistent condom use, further efforts to promote the NYC Condom brand would be easily justified.
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Racial residential segregation has been associated with an increased risk for heart disease and stroke deaths. However, there has been little research into the role that candidate mediating pathways may play in the relationship between segregation and heart disease or stroke deaths. In this study, we examined the relationship between metropolitan statistical area (MSA)-level segregation and heart disease and stroke mortality rates, by age and race, and also estimated the effects of various educational, economic, social, and health-care indicators (which we refer to as pathways) on this relationship. ⋯ Among whites, segregation was marginally associated with heart disease mortality rates in the younger age group and was positively associated with heart disease mortality rates in the older age group. Three of the potential pathways we explored attenuated relationships between segregation and mortality rates among both blacks and whites: percentage of female-headed households, percentage of residents living in poverty, and median household income. Because the percentage of female-headed households can be seen as a proxy for the extent of social disorganization, our finding that it has the greatest attenuating effect on the relationship between racial segregation and heart disease and stroke mortality rates suggests that social disorganization may play a strong role in the elevated rates of heart disease and stroke found in racially segregated metropolitan areas.
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Respondent-driven sampling (RDS) is an increasingly common sampling technique to recruit hidden populations. Statistical methods for RDS are not straightforward due to the correlation between individual outcomes and subject weighting; thus, analyses are typically limited to estimation of population proportions. This manuscript applies the method of variance estimates recovery (MOVER) to construct confidence intervals for effect measures such as risk difference (difference of proportions) or relative risk in studies using RDS. ⋯ MOVER is then applied to obtain a confidence interval for the relative risk between education levels and HIV seropositivity and current infection with syphilis, respectively. This approach provides a simple method to construct confidence intervals for effect measures in RDS studies. Since it only relies on a proportion and appropriate confidence limits, it can also be applied to previously published manuscripts.