Journal of urban health : bulletin of the New York Academy of Medicine
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Despite mounting evidence that urban greenspace protects against mortality in adults, few studies have explored the relationship between greenspace and death among infants. Here, we describe results from an analysis of associations between greenness and infant mortality in Philadelphia, PA. We used images of the normalized difference vegetation index (NDVI), derived from processed satellite data, to estimate greenness density in each census tract. ⋯ The following variables were included as potential confounders and effect modifiers: percentage non-Hispanic black, percentage living below the poverty line, an indicator of housing quality, and population density. In adjusted models, the rate of infant mortality was 27% higher in less green compared to more green tracts (95% CI 1.02-1.59). These results contribute further evidence that greenspace may be a health promoting environmental asset.
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Existing research indicates that justice-involved individuals use a variety of different drugs and polysubstance use is common. Research shows that different typologies of drug users, such as polydrug users versus users of a single drug, have differing types of individual-, structural-, and neighborhood-level risk characteristics. However, little research has been conducted on how different typologies of drug use are associated with HIV risks among individuals in community corrections and their intimate sex partners. ⋯ Polydrug users and mild polydrug users were also more likely to have risky sex partners and higher rates of criminal justice involvement. There is a need to provide HIV and drug use treatment and linkage to service and care for men in community correction programs, especially polydrug users. Community correction programs could be the venue to provide better access by reaching out to this high HIV risk key population with increased rates of drug use and multiple sex partners.
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Women who inject drugs are disproportionately affected by co-occurring intimate partner violence (IPV), poor mental health, and substance use. Less is known about the potentially synergistic effects of these factors on women's HIV risk behavior, and no known studies in Asia examine these relationships. This study assessed the additive and interactive effects of exposure to syndemic IPV, depressive symptoms and non-injection crystal methamphetamine (crystal meth) on HIV sexual risk behaviors in the largest cross-sectional sample of women who inject drugs in Indonesia. ⋯ Specifically, significant positive interaction was observed between IPV and crystal meth on inconsistent condom use (AP = 0.38, p < 0.05); depressive symptoms and crystal meth on STI symptomatology (RERI = 2.04, p < 0.001; AP = 0.61, p < 0.001) and survival sex (RERI = 1.20, p < 0.01; AP = 0.53, p < 0.01); and IPV and depressive symptoms on STI symptomatology (RERI = 3.01, p < 0.01; AP = 0.52, p < 0.001; S = 2.70, p < 0.01) and survival sex (RERI = 1.21, p < 0.05; AP = 0.40, p < 0.05). This study provides new empirical evidence showing that the syndemic conditions of IPV, depressive symptoms and crystal meth consumption interact synergistically to increase women's HIV risk. Interventions that consider the full scope of syndemic vulnerabilities, rather than addressing individual conditions separately, may be essential.
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Overdose prevention sites (OPS) are places where people use previously obtained drugs under the supervision of a health professional. They have been proposed in six United States (US) cities, including Philadelphia, to help reduce opioid-related overdose deaths and public injection. Philadelphia has the highest overdose rate among large cities in the US, which has led a local community-based organization to plan the implementation of OPS. ⋯ A greater proportion of Asian/Pacific Islanders, Hispanic/Latinx respondents, and non-Hispanic/Latinx Black respondents were in favor of an OPS opening in Kensington compared with white respondents (p < 0.04). While details about implementation are still being considered, results indicate general acceptability among Kensington residents and businesses for an OPS, especially if it can deliver benefits that curb drug-related social problems. Should an OPS be implemented in Philadelphia, it would be important to monitor changes in drug-related social problems and acceptability post implementation.
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Exchanging money, drugs, and other goods for sex has been associated with sexual risk behaviors and increased STIs/HIV. While female sex work is well described, data on men who exchange sex for money or goods are more limited. This paper examined the prevalence and correlates of transactional sex among young men who have sex with men, especially focusing on substance use and HIV status. ⋯ Based on multivariable analyses after adjusting for age and race/ethnicity, HIV viral load was independently associated with transactional sex [adjusted odds ratio (AOR) = 1.4; 95% confidence interval (CI) 1.1-1.7) per log10 increase]. Additionally, those testing positive for an STI were nearly twice as likely to report transactional sex as compared to those without STIs (AOR = 1.9; 95% CI 1.2-3.5). These findings underscore the relatively high prevalence of transactional sex and its potential role in ongoing HIV transmission among this cohort of high-risk HIV-negative and HIV-positive men who have sex with men.