Journal of urban health : bulletin of the New York Academy of Medicine
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Female sex workers are a structurally vulnerable population, including critical insecurity such as having access to food and shelter. This risk may be heightened among individuals who enter sex work as minors. However, the reasons for entering sex work as a minor and the long-term structural risk implications are poorly understood. ⋯ This study highlights that those who trade sex at a younger age experience an ongoing cumulative vulnerability in comparison to those entering over the age of 18. These findings call for additional research into a more detailed understanding of young women's entry into the sex trade and trajectory. A focus on the importance of policy changes and structural interventions that directly alleviate young people's socio-economic disadvantage is needed.
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The distribution of violence, sexually transmitted infections, and substance use disorders is not random, but rather the product of disease, behavior, and social conditions that co-occur in synergistic ways (syndemics). Syndemics often disproportionately affect urban communities. Studies of syndemics, however, rarely apply consistent measures of social conditions. ⋯ The magnitude varied based on specification: odds of sex-drug-violence exposure were greater for low vs. high latent SS class (OR = 6.25; 95%CI = 2.46, 15.96) compared with low vs. high SS category (OR = 2.64; 95%CI = 1.29, 5.39). A latent class characterized by residential instability was associated with greater likelihood of risk-a relationship that would have been missed with SS characterized only as an ordinal category. SS reliably captured social conditions associated with sexual, drug, and violence risks, and both quantity and quality of SS matter.
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Black women are disproportionately impacted by HIV and depression has been linked to negative HIV outcomes. Little attention has been given to social/structural factors that may drive depression among Black women living with HIV (BWLWH), including discrimination and gendered racial microaggressions (GRM). ⋯ GRM and race- and HIV-related discrimination were significantly associated with depressive symptoms and increased likelihood of MDE, but only GRM contributed uniquely in associations with both. Interventions targeting depression among BWLWH should address GRM and race- and HIV-related discrimination.
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Persons with disabilities (PWDs) living in cities during the COVID-19 pandemic response may be four times more likely to be injured or die than non-disabled persons, not because of their "vulnerable" position but because urban health policy, planning and practice has not considered their needs. In this article, the adverse health impacts on PWDs during the COVID-19 pandemic reveals the "everyday emergencies" in cities for PWDs and that these can be avoided through more inclusive community planning, a whole-of-government commitment to equal access, and implementation of universal design strategies. ⋯ We suggest that the current pandemic be viewed as an opportunity for significant urban health reforms on the scale of the sanitary and governance reforms that followed ninetieth century urban epidemics. This perspective offers insights for ensuring the twenty-first century response to COVID-19 focuses on promoting more inclusive and healthy cities for all.