Journal of urban health : bulletin of the New York Academy of Medicine
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Hispanic/Latino persons are disproportionately impacted by HIV in the US, and HIV diagnoses among Hispanic/Latino men in Georgia have increased over the past decade, particularly in metropolitan Atlanta. In 2022, the Georgia Department of Public Health detected five clusters of rapid HIV transmission centered among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM) in metropolitan Atlanta. We conducted in-depth interviews with 65 service providers and 29 HLMSM to identify barriers and facilitators to HIV service access for HLMSM. ⋯ Finally, the HLMSM community is characterized by its diversity, and there is not a one-size-fits-all approach to providing appropriate care to this population. The collection of qualitative data during an HIV cluster investigation allowed us to quickly identity barriers experienced by HLMSM when accessing HIV and other medical care, to optimize public health response and action. Well-designed program evaluation and implementation research may help elucidate specific strategies and tools to reduce health disparities, ensure equitable service access for HLMSM, and reduce HIV transmission in this population.
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This article uses ethnographic and qualitative research to explore the health implications and social responses of a low-income neighborhood in Southeast England, to more than a decade of austerity policies and declining institutional and welfare support. Findings examine how cuts to public services and welfare programs alongside changes to the area's social structure shape resident's perceptions of health risks and threats. Residents pointed to poor levels of mental health that were exacerbated by financial insecurity, the closure of community facilities and difficulties accessing support and professional help. ⋯ Many people felt their neighborhood was treated inequitably with regard to law-and-order, health provision and other services designed to address health problems and risks and dangers in their social environment. This institutional vacuum generates unmet health needs facilitating informal practices and methods for managing health, such as through self-provision or using alternative, and more readily available, sources of medical advice and treatment. The demise of older forms of social control and surveillance that ran parallel with closure of the area's communal spaces had been partly compensated by social media usage, while informal methods of policing were a growing presence in the neighborhood in reaction to rising lawlessness and the ineffectiveness of police and local authorities.
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The 2022-2023 mpox outbreak has disproportionately impacted gay, bisexual, and other men who have sex with men (GBMSM). The US CDC recommended individuals to explore safer sexual practices that minimize the potential risk of exposure and also strongly encouraged for eligible individuals to prioritize vaccination. This study aimed to analyze social media data related to mpox on Reddit since the mpox outbreak and identify themes associated with the impact on social behaviors and social processes among targeted population. ⋯ GBMSM changed their sexual behaviors and social activities to mitigate their exposure to the virus during this outbreak and actively sought and shared information about mpox vaccination in their respective settings, while some were hesitant due to concerns about side effects and potential effectiveness. Perceived and experienced stigma and discrimination on gay- and same sex-identify have impacted GBMSM's mental health. Interventions to promote the mpox vaccine must address the historical medical mistrust and vaccine hesitancy among GBMSM.
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Gun-related violence exposure is a significant public health problem for urban youth. Few studies have implemented methods to estimate the spatial influence of activity spaces on gun violence exposure constrained by the physical configuration of walkable street networks. The present research uses computational network and local indicators of spatial autocorrelation methods to explore gun violence exposure along the walkable streets near schools in Compton, California. ⋯ Almost all schools had at least one shooting within a 5-min walk (i.e., about 400 m); 37.8% of schools had an average shooting distance of less than 400 m; about 250 incidents occurred within 5 min of schools; and about 30 schools had a shooting within a 5-min walking distance. Determining the spatial extent of violence exposure in proximity to key activity spaces for youth, such as schools, has substantial implications for the health and wellbeing of youth living in violence-prone areas. The public health and legal implications of this study are discussed in context.
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The COVID-19 pandemic highlighted several challenges that cities face that can affect the health of urban populations. These challenges are an opportunity for sharpening of our urban health scholarship, to rethink the questions the field should be asking, and how the answers to those questions should guide practice. The central role of inequities in cities, the politics of urban health, communication for health, the deployment of health care, and the future of urban living are all areas that merit attention by scholars and practitioners in the field in coming decades.