Provider love in an informal settlement: Men's relationships with providing women and implications for HIV in Kampala, Uganda.

Uganda has made progress in controlling the HIV epidemic since it first emerged in the 1980s. While new infections in the country are higher among women, men in urban areas face a higher risk of AIDS-related mortality due to starting treatment later and taking medication inconsistently. While gender analyses have been used to describe women's HIV vulnerability, less is known about how masculinity, and especially different forms of masculinity, affect men's vulnerability. This study reports on data from an ethnography (2016-2019) with low-income men in urban Uganda. This study uses gender and power theory to describe how men's relationships with female sex workers in an informal settlement in urban Kampala, Uganda are characterized by female providers ("provider love") and male dependents. Young men in this sample, largely jobless, rely on their relationships for daily survival. As gender roles reverse, young men find themselves unable to attain masculine ideals as expected of Baganda men. Instead, men in this sample face less power in their relationships, a loss of masculine respectability, and diminished reputations in the community. These intersections of gender, economic struggle, power, and intimacy reconfigure men's HIV vulnerability in this setting. Public health programming on HIV/AIDS for men should consider different patterns of masculinity, power, and economic struggle and how they impact HIV outcomes.

Challenges to Ebola preparedness during an ongoing outbreak: An analysis of borderland livelihoods and trust in Uganda.

Ebola Virus Disease in the Democratic Republic of Congo (DRC) was declared a public health emergency of international concern on July 17, 2019. The first case to cross the border into Uganda in June 2019 demonstrates the importance of better understanding border dynamics in a context of Ebola. This paper adopts a political economy approach to contextualize epidemic response programs conducted in moderate- and high-risk border districts in Uganda, through a qualitative study with 287 participants. To that end, our aim was to describe the historical underpinnings of the borderlands context; the role of livelihood strategies in constraining risk avoidance decisions; and the dynamics of trust in authority figures, including health workers. This paper reports that border communities are highly connected, for a variety of social and economic reasons. These daily realities are in direct opposition to guidance to limit travel during an active Ebola epidemic. We argue that an ability to limit movement is constrained by the economic need to seek livelihood strategies wherever that may be. Moreover, border regions are populated by communities with long-standing distrust in authority figures, particularly in fishing areas. This distrust spills over with consequences for Ebola prevention and control activities. This research indexes the importance of tailoring Ebola programming and policies to consider the political and economic dynamics of borderlands.

How might neighborhood built environment influence child maltreatment? Caregiver perceptions.

RATIONALE: Child maltreatment remains a serious but potentially preventable public health concern in the United States. Although research has examined factors associated with child maltreatment at the neighborhood level, few studies have explicitly focused on the role of the neighborhood built environment in maltreatment. OBJECTIVE: We begin to address these gaps by investigating caregivers' own perceptions of mechanisms by which neighborhood built environments may affect child maltreatment. METHOD: Utilizing a grounded theory approach, we examined open-ended interview data from 400 adult residents residing in 20 different Cleveland, Ohio neighborhoods (census tracts) and caring for at least one child under 18 years of age. RESULTS: Our analysis revealed three primary pathways through which caregivers linked the neighborhood built environment to potential child maltreatment: housing density, physical neighborhood space as shaping family relations, and the internalization of the surrounding neighborhood-built environment. CONCLUSIONS: Our findings suggest that aspects of the neighborhood built environment, such as the presence of abandoned houses or the lack of recreational centers, can be stressors themselves and may also critically alter families' thresholds for navigating other everyday pressures. Conversely, aspects of the neighborhood built environment, such as housing density, may work to mitigate the risk of maltreatment, either by promoting social support or by increasing the likelihood that maltreatment is reported to authorities. Additional research, both qualitative and quantitative, is integral to building and testing models of these separate but related pathways by which the neighborhood built environment may link to child maltreatment.

Community vulnerability and stratified risk: Hegemonic masculinity, socioeconomic status, and HIV/AIDS in a sex work community in Kampala, Uganda.

This article examines the social patterning of health, economic uncertainty, hegemonic masculinity, and vulnerability among men who live and work in a low-income sex work community in Kampala, Uganda. This problematises the notion that vulnerable communities are homogenous, in demographics, economic status, and risk. This article draws on ethnographic data collected in 2016, including semi-structured interviews and participant observation. This article uses a stratified risk framework to describe the central finding of this study, which is that men's experience in Kataba is characterised by a struggle to fulfil the provider role that constitutes a core aspect of their socially ascribed gender role. In a context of economic scarcity, men's lives are fraught with strain and this intersects with other forms of risk. Finally, by focusing on community vulnerability rather than individual risk, this work contributes to theories of gender and sex work, and informs HIV/AIDS praxis.