Low-income Men Research Articles

Low Income, Ill-being, and Gender Inequality: Explaining Cross-National Variation in the Gendered Risk of Suffering Among the Poor

Scholars have long investigated the positive link between income and well-being, including its gender difference. However, little is known about (1) how low income is linked to ill-being among women and men; and (2) how their association varies depending on societal-level gender (in)equality. Filling this knowledge gap is crucial not only for scholarship but for social policy to tackle income-based disparities of ill-being. In this study, using the European Social Survey and the joint European Values Study-World Values Survey data, we conduct country-specific regressions and cross-national multilevel analyses to examine the relationship between low income, subjective ill-being (SIB), and macro-level gender parity. We first confirm that low-income individuals, regardless of gender, are more likely than their affluent counterparts to suffer from SIB in many countries. This indicates the applicability of implications derived from conventional approaches focused on the positive association between higher income and better well-being to the studies on low income and SIB. Nevertheless, the SIB risk significantly differs depending on the degree of gender inequality in that (1) both women and men face a higher likelihood of SIB in gender-inegalitarian societies; and importantly, (2) the psychological penalty for the poor is intensified under such gendered circumstances, especially among men. These results suggest that gender inequality not merely induces women’s ill-being but punishes low-income men possibly by exacerbating pressure as a breadwinner and imposing stigmas when they cannot meet gendered social expectations.

Early national trends in non-abortion reproductive care access after Roe.

Roe was overturned in 2022. No peer-reviewed evidence exists for the indirect spillover effects of overturning Roe on non-abortion reproductive care access for diverse patient populations. National data were from 2013-2023 HHS Title X Directory, 2013-2020 CDC Artificial Reproductive Technologies (ART) Surveillance and 2021-2023 manual collection, and Guttmacher Institute. Outcome measures included numbers of ART clinics and Title X entities. Title X entities are those that receive federal funds to establish and operate voluntary family planning projects, especially for low-income patients. We reported pre-and post-Roe changes, associations between changes in measures and abortions, and characteristics of changed measures by region and political geography. Post-Roe America witnessed national declines of 1.03% in ART clinics and 18.34% in Title X entities, and average state decreases of 0.08 ART clinics (p < 0.05) and 18 Title X entities (p < 0.001). State-level ART clinic closures and abortion reductions had little association except for Texas, Oklahoma, Arizona, New York, and California. Plummets in Title X entities and abortions were positively associated: Reducing 100 abortions was associated with defunding two Title X entities (p < 0.05). The South experienced the largest losses of both, while 83.39% of lost Title X entities were in states that voted Republican in the 2020 presidential election, disproportionate to the 49.02% of states that voted Republican and the 42.52% of US population residing in these states. We provide one of the first few evidence of spillover impacts of overturning Roe on non-abortion care access for diverse populations: low-income men and women, single parents by choice, and biologically and socially infertile patients. Early evidence warns of worsening challenges of inequities and calls for immediate policy actions.

A qualitative study of barriers and facilitators for health behavior change in low-income men with prostate cancer.

Low-income prostate cancer survivors, who typically have worse outcomes and greater all-cause mortality, often have poor health-promoting behaviors. Our objective was to assess perceived facilitators of and barriers to healthy behavior change by interviewing low-income men with prostate cancer who received no-cost treatment through a state-funded program. Between September 2021 and April 2022, we conducted semi-structured interviews with 19 men (ages 60-75). Purposive sampling was utilized from participants of a cohort of men with prostate cancer from low-income backgrounds. Interviews were recorded, transcribed, and then coded by the authors to generate salient themes via thematic analysis. We found internal characteristics and structural characteristics that functioned independently and in concert to promote and/or hinder healthy behavior change. Internal characteristics such as motivations (prostate cancer diagnosis, self-perceptions, support system, and preferences) and determination, defined as level of motivation, drove behavior actualization. Structural characteristics that influenced behavior change included resources (access to food and opportunities for exercise) and social support. These outcomes suggest that motivation and determination can serve as protective facilitators encouraging healthy behaviors despite structural barriers low-income prostate cancer survivors may face. However, motivations challenged by financial constraints were not sufficient to guide healthy behavior change. With this in mind, we recommend that interventions promoting healthy behavior change among this population should focus on identifying and strengthening internal assets such as motivations, self-perceptions, preferences, and support systems.

Association of neighborhood gentrification with prostate cancer and immune markers in African American and European American men.

Prior studies showed that neighborhood deprivation increases the risk of lethal prostate cancer. However, the role of neighborhood gentrification in prostate cancer development and outcome remains poorly understood. We examined the relationships of gentrification with prostate cancer and serum proteome-defined inflammation and immune function in a diverse cohort. The case-control study included 769 cases [405 African American (AA), 364 European American (EA) men] and 1023 controls (479 AA and 544 EA), with 219 all-cause and 59 prostate cancer-specific deaths among cases. Geocodes were linked to a neighborhood gentrification index (NGI) derived from US Census data. Cox and logistic regression, and MANOVA, were used to determine associations between NGI, as continuous or quintiles (Q), and outcomes. Adjusting for individual socioeconomic status (SES), continuous NGI was positively associated with prostate cancer among all men (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14). AA and low-income men experienced the highest odds of prostate cancer when residing in tracts with moderate gentrification, whereas EA men experienced reduced odds of regional/metastatic cancer with increased gentrification in SES-adjusted analyses. Continuous NGI also associated with mortality among men presenting with localized disease and low-income men in SES-adjusted Cox regression analyses. NGI was not associated with serum proteome-defined chemotaxis, inflammation, and tumor immunity suppression. Findings show that neighborhood gentrification associates with prostate cancer and mortality in this diverse population albeit associations were heterogenous within subgroups. The observations suggest that changing neighborhood socioeconomic environments may affect prostate cancer risk and outcome, likely through multifactorial mechanisms.

Impact of income inequalities on subjective perception of older adult health: An analysis of healthy life expectancy in China from 1997 to 2006.

Driven by rapid socioeconomic development over recent decades, there are widening income inequalities and subjective health disparities among older adults in China. This study explored the relationship between income inequalities and self-rated healthy life expectancy (HLE) considering potential sex-specific differences. From a cohort of 1760 individuals aged ≥60 years from the China Health and Nutrition Survey (1997-2006), we calculated age-specific life expectancy (LE), HLE and the proportion of HLE to LE (HLE/LE) by sex using the IMaCh software, incorporated time-varying income levels of older adults. Although longevity has significantly improved, the well-being of Chinese older adults could be further enhanced by assessing HLE, as the results showed that at age 60 years, ~20% of their LE was characterized by unhealthiness. Discriminated by economic status, lower-income individuals experienced worse self-rated health compared with the general population and affluent counterparts. For instance, at age 60 years, the LE, HLE and HLE/LE of low-income men were 19.8 (95% CI 18.4-21.1), 16.2 years (95% CI 15.0-17.5) and 81.8%, respectively, lower than their general (21.7, 95% CI: 20.4-23.0; 18.0, 95% CI 16.8-19.2; and 82.9%) and high-income counterparts (25.1, 95% CI 23.1-27.2; 21.4, 95% CI 19.5-23.3; and 85.3%). Sex disparities were noticeable among low-income individuals in HLE/LE, with low-income women showing the most significant disadvantage. Income inequalities exacerbated subjective health disparities among older adults, particularly among lower-income individuals and women. Our findings carry significant implications for formulating public health and social welfare strategies, especially in nations grappling with an aging population and undergoing parallel socioeconomic development. Geriatr Gerontol Int 2024; 24: 109-115.

Low Human Papillomavirus Vaccination in a Low-Income Urban Population.

Despite widespread availability of human papillomavirus (HPV) vaccines and recommendations for routine use, awareness and uptake of HPV vaccination are not universal. We assessed self-reported history of HPV vaccination in a sample of low-income men and women recruited from the community using respondent-driven sampling as part of the National HIV Behavioral Surveillance (NHBS) survey in San Francisco. Of the 384 respondents, a minority (12.5%) reported they had received the HPV vaccine. In multivariate analysis, independent associations with HPV vaccination history were female sex (adjusted odds ratio [AOR] = 3.76, 95% confidence interval [CI] = [1.73, 8.17]), younger age (AOR = 0.89 per year, 95% CI = [0.86, 0.92]), and education above high school (AOR = 2.84, 95% CI = [1.37, 5.90]). Missed opportunities for HPV vaccination were evident in 84.4% of respondents having visited a health care provider in the last year, including 40.1% tested for a sexually transmitted infection, and entry into higher education programs (33.4%).

Experiences of police-related stress among a U.S.national cohort of gay and bisexual men.

Marginalized groups (including people of Color and sexual minorities) have been over-policed and specifically targeted based on their race/ethnicity and identity. The deleterious effects of over-policing marginalized groups include overrepresentation in the carceral system, experiencing higher rates of violence from police, and extend to affect mental healthand stress levels. This study examines police-related stress among a U.S.national cohort of gay and bisexual men (collected in late 2020 and early 2021) and its association with race/ethnicity, age, human immunodeficiency virus(HIV) status, income, and other characteristics of interest. Our results show that the odds of reporting extreme police-related stress were 2.7 (95% confidence interval [CI] [2.08, 3.41]) times higher for Black individuals than for their White counterparts. Odds were also significantly greater for those who have experienced race-based (odds ratio [OR] = 2.26, 95% CI [1.81-2.82] or identity-based discrimination (OR = 2.05, 95% CI [1.66, 2.54]). Our findings demonstrate variation in police-related stress among a cohort of gay and bisexual men; with men of Color and low-income men among the most affected by police-related stress. For this population, police-related stress should be considered for its potential deleterious effect on HIV vulnerability and reporting violent crimes to police (including intimate partner violence and hate crimes).

Effects of the affordable care Act's Medicaid expansion on health insurance coverage for individuals in same-sex couples.

To examine whether the Affordable Care Act's (ACA's) Medicaid expansions affected health insurance coverage for individuals in same-sex couples. We used data on adults aged 18-64 years in same-sex couples (n=33,512) from the 2008-2018 American Community Survey (ACS). To estimate the effect of the impact of the state Medicaid expansions under the ACA on health insurance coverage for sexual minorities, we utilize a standard difference-in-differences approach to leverage the variation across geography and time in expanding Medicaid. Secondary and publicly available ACS data were obtained from IPUMS at the University of Minnesota. We find that Medicaid expansion significantly increased health insurance coverage among low-income men and women in same-sex couples by 4.9 (standard error [SE]=1.75) and 6.5 (SE=1.96) percentage points, respectively. We find increases in the likelihood of having Medicaid and reductions in private health insurance from an employer or privately purchased insurance. Effects on Medicaid take-up are consistently larger for low-income women in same-sex couples as compared to low-income men in same-sex couples. We provide the first evidence on the relationship between state Medicaid expansions under the ACA and health insurance coverage among sexual minority adults, a group that has been understudied in past research. Our results confirm that sexual minority adults benefitted from the ACA's Medicaid expansions with respect to increased health insurance coverage.

Impact of Comprehensive Health Insurance on Quality of Life in Low-Income Hispanic Men with Prostate Cancer

ObjectiveTo evaluate the effect of the transition from IMPACT, a disease-focused treatment program, to comprehensive health insurance under Medicaid through the Affordable Care Act (ACA) on general and prostate cancer-specific quality of life (QoL) on a cohort of previously uninsured low-income men. We hypothesize that general QoL would improve and prostate cancer-specific QoL would remain the same after the transition to comprehensive health insurance. MethodsWe assessed and compared general QoL using the RAND SF-12v2™ (12-Item Short Form Survey, version 2) and prostate cancer-specific QoL using the UCLA PCI (Prostate Cancer Index) one year before, at, and one year after the transition between 30 men who transitioned to comprehensive insurance (newly insured/Medicaid group) and 54 men who remained in the prostate cancer program (uninsured/IMPACT group). We assessed the independent effects of Medicaid coverage on QoL outcomes using repeated-measures regression. ResultsOur cohort was composed primarily of Hispanic men (82%). At transition, patient demographics and clinical characteristics were similar between the groups. General and prostate cancer-specific QoL did not differ between the groups and remained stable over time, Radical prostatectomy as primary treatment and shorter time since treatment were associated with worse urinary and sexual function across both groups and over all three time points. ConclusionThose who transitioned to full-scope insurance and those who remained in the free prostate cancer-focused treatment program had stable general and prostate cancer-specific QoL. High-touch navigation aspects of a disease-focused program may have contributed to stability in outcomes.

Vulnerabilities to Food Insecurity: Interconnected Risks and Assets for Coping Among Low-Income Men

Objective: A consideration of low-income men’s social, economic, and environmental contexts reveals potential vulnerabilities to food insecurity, yet their experiences of food insecurity have not been well documented. As such, this paper explores the risks and assets for food insecurity as described by a sample of 30 low-income men. Method: Data were collected through in-depth semistructured interviews that took place in 11 Department of Social Services offices in five geographically diverse Maryland counties. We used thematic analysis to analyze the data. Findings: Participants reported experiencing multiple, co-occurring, and accumulating hardships that interfered with meeting basic needs and accessing food. Risks included health problems, limited employment, lack of transportation, and housing problems. Assets for coping included financial management skills, relationships, and public and private community assistance, particularly SNAP. Conclusions: Findings indicate that although policies and programs targeting one area of hardship may help meet immediate needs, they do not address the interconnected root causes and consequences of poverty. Policies and programs should support and leverage existing assets of low-income men to amplify programmatic benefits.

The association between preventive health and outpatient spending and life expectancy by income quartile

BackgroundTo describe the relationship between longevity and local access to preventive healthcare at the county level.MethodsWe used Medicare outpatient reimbursement data from the 2010 Dartmouth Health Atlas and longevity data from Chetty et al. (2016) to identify the cross-sectional associations between county longevity, access to outpatient care, and the quality of primary care.ResultsWe find that the cost of outpatient care is inversely correlated with area life expectancy for individuals in the bottom income quartile. Much of this correlation is driven by men in the bottom income quartile. We also find that disaggregating a preventive care index produces significant relationships between components of the index and longevity where none were previously found.ConclusionsThese results counter prior assertions that local health costs are not associated with life expectancy. Additionally, the results also suggest that the local cost of outpatient care and the quality of that care may influence the longevity of low-income populations, especially for low-income men.

ATTITUDE TOWARDS FAMILY PLANNING: KNOWLEDGE AND PERCEPTION OF TRANSPORT WORKERS IN KHULNA CITY CORPORATION (KCC) OF SOUTHWEST BANGLADESH

This study deciphers the relationship among socio-demographic and economic conditions with the attitude towards restricting family size as well as knowledge and perception of the low income people in this regard. By administering a interview schedule, data used in this article were collected purposively from four hundred and forty low-income men from Khulna City Corporation (KCC) areas of Bangladesh following survey research design. It was found that men’s personal and household socio-demographic and economic conditions were the key determinants to their access to and use of family planning methods. Low-income men in their thirties with more years of schooling and disposal income played pivotal role in making decisions regarding use of contraceptives. The knowledge and perception on family planning were influenced by their social, economic as well as demographic characteristics. Such attributes eventually influenced the frequency and willingness to use family planning methods to minimize the family size of low income people in urban Bangladesh.

Investigating the impact on mental wellbeing of an increase in pensions: A longitudinal analysis by area-level deprivation in England, 1998–2002

In 1997 approximately two million people aged 60 years or over were living poverty in the UK. In 1999 the UK Government raised real pension incomes of low-income pensioners by around a third through the introduction of the Minimum Income Guarantee (MIG). This study explores the implications of this change for pensioners’ mental wellbeing with a focus on differences by area level deprivation in England. We explore mental wellbeing outcomes of 205 men (750 person-year observations) and 367 women (1,336 person-year observations) of state pension age from scores on the General Health Questionnaire from the British Household Panel Survey using a panel difference-in-difference estimation procedure. We compare the mental wellbeing of pensioners receiving MIG to that of low-income pensioners not claiming MIG, from 1998 to 2002. To investigate differences by area deprivation we use quintiles of the of the distributions of the 2000 and 2019 local-authority-level English Index of Multiple Deprivation. Models controlled for age, marital status and year. Between 1998 and 2002, 136 (38%) of low-income women and 57 (28%) of low-income men in the sample were claiming MIG at any one time. Income increased by 31% for men and 22% for women. There was no change in mental wellbeing for women but we found an improvement for men overall and for men living in the most deprived areas, in the latter case with a decrease of the GHQ-12 score of 2.43 points (95% CI: −5.49, 0.02). This estimate was similar across all measures of deprivation, and across both years of IMD. This study provides tentative evidence that the increase in pension income in England for low-income pensioners contributed to a reduction of inequalities in mental wellbeing for men. This needs to be considered in terms of future state pension policies.

Social and behavioral factors related to blood pressure measurement: A cross-sectional study in Bhutan

Cardiovascular disease is a leading cause of death in the Kingdom of Bhutan, and early detection of hypertension is critical for preventing cardiovascular disease. However, health-seeking behavior, including blood pressure measurement, is infrequently investigated in Bhutan. Therefore, this study investigated factors related to blood pressure measurement in Bhutan. We performed a secondary data analysis of a target population of 1,962 individuals using data from the "2014 Bhutan STEPS survey data"as a cross-sectional study. Approximately 26% of those with hypertension who were detected during the STEPS survey had never had their blood pressure measured. Previous blood pressure measurement was significantly associated with age and working status in men (self-employed [odds ratio (OR): 0.219, 95% CI: 0.133-0.361], non-working [OR: 0.114, 95% CI: 0.050-0.263], employee [OR: 1.000]). Previous blood pressure measurement was significantly associated with higher income in women (Quartile-2 [OR: 1.984, 95% CI: 1.209-3.255], Quartile-1 [OR: 2.161, 95% CI: 1.415-3.299], Quartile-4 [OR: 1.000]). A family history of hypertension (OR: 2.019, 95% CI: 1.549-2.243) increased the likelihood of having experienced a blood pressure measurement in both men and women. Multivariate logistic regression showed that people with unhealthy lifestyles (high salt intake [adjusted odds ratio (AOR): 0.247, 95% confidence interval (CI): 0.068-0.893], tobacco use [AOR: 0.538, 95% CI: 0.380-0.761]) had a decreased likelihood of previous blood pressure measurement. To promote the early detection of hypertension in Bhutan, we suggest that more attention be paid to low-income women, non-working, self-employed, and low-income men, and a reduction of barriers to blood pressure measurement. Before the STEPS survey, a substantial number of hypertensive people had never had their blood pressure measured or were unconcerned about their health. As a result, we propose that early blood pressure monitoring and treatment for people with hypertension or at higher risk of hypertension be given increased emphasis.

Co-payment and adolescents' use of psychologist treatment: Spill over effects on mental health care and on suicide attempts.

The literature around co-payment shows evidence of increasing consumption following reduced co-payment. We apply difference-in-difference methods to assess the effect of abolishing the co-payment on psychologist treatment of anxiety and depression in 18 to 21-year olds. We apply nationwide individual level data with individuals close to this age interval as control group. The population amounts to approximately 1.2 million individuals and a total of 51 million patient months of observations. We show that after removing co-payment, the use of psychologist treatment almost doubles. We find that this increase involves moderately positive spill over effects on outpatient psychiatric care and on prescriptions of antidepressants. In the heterogeneity analysis we find evidence of higher effects on adolescents from families with lower income, indicating that reduced co-payments may increase equality in access. We also see that effects are higher for individuals listed with general practitioners (GPs) with a reluctant referral style; indicating that these GPs' behavior is affected by patient co-payment rates. Interestingly, we find evidence of significant reductions in suicide attempts - primarily among high-income women and low-income men. This indicates that better access to mental health care for adolescents may have a positive impact on their mental health and well-being.

Quality of life in low-income men after surgical castration for metastatic prostate cancer.

To compare health-related quality of life in men who underwent surgical vs. medical castration for metastatic prostate cancer. We analyzed data from a prospective cohort of men enrolled in a statewide public health program that provides care for prostate cancer among low-income, uninsured men from 2001 to 2020. Outcome measures included the RAND SF-12 and the UCLA Prostate Cancer Index (PCI) at baseline and every 6 months. We used generalized estimating equations to assess the independent impact of surgical vs. medical castration on health-related quality of life. Among men with metastatic prostate cancer, 27 underwent orchiectomy, and 274 underwent medical castration. Median cohort age at enrollment was 61.3 years (IQR 56-65); 239 (79%) men had less than a high school education. Average follow-up was 8 months (range 0-45) since study enrollment. Seventy percent of patients within the surgical castration group had their orchiectomy prior to study enrollment (median months since orchiectomy at study enrollment was 9 months, IQR 1-43). Similarly, 59% of patients within the medical castration group had begun ADT prior to study enrollment (median months since ADT initiation at study enrollment was 4 months, IQR 1-12). The majority (66%) had metastatic disease at diagnosis. The 2 groups did not differ in age, race/ethnicity, education, monthly income, baseline PSA, Gleason score, or percent metastatic at diagnosis. SF-12 domains did not differ between those who underwent surgical vs. medical castration (on average throughout follow-up, physical component difference -2.0, 95% CI -8.0-3.9 and mental component difference -1.0, 95% CI -5.4-+3.4). Patients treated with orchiectomy reported better urinary function than those who underwent medical castration (+16 point, 95%CI 5.3-26). Surgical castration did not negatively impact general or disease-specific quality of life. The finding of improved urination after orchiectomy merits further inquiry. This may inform urologists' discussion of surgical vs. medical options for men with castration-sensitive metastatic prostate cancer.

When disadvantage collides: The concentrated effects of energy insecurity and internet burdens in the United States

Energy and internet insecurity are exacerbated by the compounding of multiple forms of social-economic disadvantage during extreme events. This study demonstrates the effects of concentrated disadvantage on internet and energy burdens and utility hardships in the United States during the COVID-19 pandemic in 2021. Based on 1991 online respondents, we found that internet and energy burdens are higher in Florida than in California, but utility hardship is greater in California. Women, renters, low-income households, and people of color have higher internet and energy burdens than their counterparts. Unique to this study, people with higher energy medical needs are more likely to suffer from energy and internet insecurity than people without such needs. Low-income women, low-income homeowners, and homeowners of color with more energy medical needs have- higher energy burdens than their counterparts. Low-income men, people of color, and Black/Latino residents with higher levels of energy medical needs, and renters with disabilities and homeowners with medical needs affected by heating and cooling experienced higher levels of utility hardship than their counterparts. These findings suggest that energy insecurity is not just determined by income but by other social and health factors. The findings provide policy implications.

PD25-05 CHANGES IN HEALTH BEHAVIORS AMONG LOW-INCOME UNINSURED MEN WITH PROSTATE CANCER

You have accessJournal of UrologyCME1 May 2022PD25-05 CHANGES IN HEALTH BEHAVIORS AMONG LOW-INCOME UNINSURED MEN WITH PROSTATE CANCER Allen E. D. Siapno, Megha D. Tandel, Lorna Kwan, and Mark S. Litwin Allen E. D. SiapnoAllen E. D. Siapno More articles by this author , Megha D. TandelMegha D. Tandel More articles by this author , Lorna KwanLorna Kwan More articles by this author , and Mark S. LitwinMark S. Litwin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002567.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with prostate cancer from low-income and uninsured backgrounds have poorer health outcomes partly due to higher risk of chronic disease and lower rates of healthy behaviors. We sought to describe the changes in health behaviors of men with prostate cancer participating in a disease-focused treatment program providing free medical care and navigation services. METHODS: We retrospectively reviewed survey data from the UCLA Men’s Health Study, a cohort quantifying patient-reported outcomes, and compared baseline surveys collected at program enrollment to 12–18-month follow-up surveys. Five health behavior domains from the California Health Interview Survey were individually and compositely scored based on adherence to the 2014 American Cancer Society Prostate Cancer Survivorship Care (ACS-PCSC) Guidelines. The scores were categorized into three adherence levels: Low, Moderate, and High. Subjects were grouped by change in adherence levels from baseline to follow-up as Worsened, No Change, or Improved. We compared patient demographics, clinical characteristics, health-related quality of life, and adherence to the five domains at baseline between the three groups. RESULTS: Of the 256 subjects eligible for analysis, 17% worsened, 52% had no change, and 31% improved in overall adherence. Most subjects identified as Hispanic (72%), were foreign born (79%), and had a partner (71%). There were no differences in clinical characteristics among the three adherence change groups. Baseline general and physical health scores were similar, but baseline mental health scores were lower in the worsened group compared to the no change and improved groups (44.3 vs 50.1 vs 47.6, respectively, p=0.0320). Those in the worsened group already had low adherence to physical activity at baseline compared to the no change and improved groups (p=0.0019) (Table 1). CONCLUSIONS: In this cohort of low-income men participating in a free navigation-based prostate cancer treatment program, 31% had improvement in overall adherence to the ACS-PCSC Guidelines for health behaviors. Worsening adherence was associated with lower baseline mental health score and physical activity adherence. Interventions aimed at physical activity may improve overall health behaviors. Source of Funding: Department of Urology, David Geffen School of Medicine, University of California Los Angeles © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e422 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Allen E. D. Siapno More articles by this author Megha D. Tandel More articles by this author Lorna Kwan More articles by this author Mark S. Litwin More articles by this author Expand All Advertisement PDF DownloadLoading ...

Male partners of female sex workers: The intersectional risk environment of HIV/AIDS in a Kampala informal settlement

AimThis study examined the context and drivers of HIV risk and vulnerability among male partners of female sex workers in Kampala, Uganda, using an “intersectional risk environment” framework. MethodsThis research reports on findings from an ethnographic study (2016–2019) of men in one informal settlement in Kabalagala Parish in Kampala. This research included long-term participant observation in and around the study community. Thematic analysis was used to assess aspects of the risk environment and how it influences HIV/AIDS among male partners of female sex workers. ResultsThe informal settlement context where sex work takes place is conceptualized here as a “risk environment,” or a social-physical space in which risk and harm are produced (Rhodes, 2002). Risk is situated within a broader social and political structure that constrains choices and facilitates HIV risk, particularly for young, low-income men facing matrices of domination on the basis of age, gender, residence, and income. These intersectionalities guide experiences of HIV vulnerability in the risk environment, including physical, social, economic, and policy risks. This includes physical risks (population density, bar density), social risks (sex work, bar groups), economic risks (informal and low wage work), and political risks (anti-poverty laws and legislation, urban policy). ConclusionThese findings highlight how an intersectional risk environment is differentially experienced by young, low-income men to produce unequal HIV/AIDS outcomes. This research fills a gap in the literature on the context of HIV/AIDS among men, particularly high-risk men like male partners of female sex workers. Using this framework will improve understandings of HIV outcomes among male partners of female sex workers and will facilitate context-specific and adapted structural interventions for HIV/AIDS prevention and treatment.

Husband’s income, wife’s income, and number of biological children in the U.S.

ABSTRACT Previous studies have found that the positive relationship between personal income and fertility for men in the United States is primarily due to childlessness among low-income men. Yet because of the opposite effects of income on fertility for men and women, it is important to examine the effects of income net of spouse’s income. An analysis of income from all sources and biological fertility data for husbands and wives from the Survey of Income and Program Participation (2014) shows that for men their own income is positively associated with the number of their biological children, while their spouse’s income is negatively associated with total children ever fathered. The reverse is true for women. These results are not because of childlessness among low-income men and high-income women, but also hold true among all those with children. For men and women aged 45–65, who likely have completed fertility, these results hold regardless of whether or not education is controlled. These findings suggest that if status is measured as personal income for men and husband’s income for women, the positive relationship between status and fertility persists in a postdemographic transition society.