Concentrations of Volatile Methyl Siloxanes in New York City Reflect Emissions from Personal Care and Industrial Use.

Volatile methyl siloxanes (VMS) are a group of organosilicon compounds of interest because of their potential health effects, their ability to form secondary organic aerosols, and their use as tracer compounds. VMS are emitted in the gas-phase from using consumer and personal care products, including deodorants, lotions, and hair conditioners. Because of this emission route, airborne concentrations are expected to increase with population density, although there are few studies in large urban centers. Here, we report summertime concentrations and daily variations of VMS congeners measured in New York City. Median concentrations of the 6 studied congeners, D3 (20 ng m-3), D4 (57 ng m-3), D5 (230 ng m-3), D6 (11 ng m-3), L5 (2.5 ng m-3), and L7 (1.3 ng m-3) are among the highest reported outdoor concentrations in the literature to date. Average congener ratios of D5:D4 and D5:D6 were consistent with previously reported emissions ratios, suggesting that concentrations were dominated by local emissions. Measured concentrations agree with previously published results from a Community Multiscale Air Quality model and support commonly accepted emissions rates for D4, D5, and D6 of 32.8, 135, and 6.1 mg per capita per day. Concentrations of D4, D5, D6, L5, and L7 and total VMS were significantly lower during the day than during the night, consistent with daytime oxidation reactivity. Concentrations of D3 did not show the same diurnal trend but exhibited a strong directional dependence, suggesting that it may be emitted by industrial point sources in the area rather than personal care product use. Concentrations of all congeners had large temporal variations but showed relatively weak relationships with wind speed, temperature, and mixing height.

Underestimation of Thermogenic Methane Emissions in New York City.

Recent studies have shown that methane emissions are underestimated by inventories in many US urban areas. This has important implications for climate change mitigation policy at the city, state, and national levels. Uncertainty in both the spatial distribution and sectoral allocation of urban emissions can limit the ability of policy makers to develop appropriately focused emission reduction strategies. Top-down emission estimates based on atmospheric greenhouse gas measurements can help to improve inventories and inform policy decisions. This study presents a new high-resolution (0.02 × 0.02°) methane emission inventory for New York City and its surrounding area, constructed using the latest activity data, emission factors, and spatial proxies. The new high-resolution inventory estimates of methane emissions for the New York-Newark urban area are 1.3 times larger than those for the gridded Environmental Protection Agency inventory. We used aircraft mole fraction measurements from nine research flights to optimize the high-resolution inventory emissions within a Bayesian inversion. These sectorally optimized emissions show that the high-resolution inventory still significantly underestimates methane emissions within the New York-Newark urban area, primarily because it underestimates emissions from thermogenic sources (by a factor of 2.3). This suggests that there remains a gap in our process-based understanding of urban methane emissions.

Scale-Up of COVID-19 Testing Services in NYC, 2020-2021: Lessons Learned to Maximize Reach, Equity and Timeliness.

During infectious disease epidemics, accurate diagnostic testing is key to rapidly identify and treat cases, and mitigate transmission. When a novel pathogen is involved, building testing capacity and scaling testing services at the local level can present major challenges to healthcare systems, public health agencies, and laboratories. This mixed methods study examined lessons learned from the scale-up of SARS-CoV-2 testing services in New York City (NYC), as a core part of NYC's Test & Trace program. Using quantitative and geospatial analyses, the authors assessed program success at maximizing reach, equity, and timeliness of SARS-CoV-2 diagnostic testing services across NYC neighborhoods. Qualitative analysis of key informant interviews elucidated key decisions, facilitators, and barriers involved in the scale-up of SARS-CoV-2 testing services. A major early facilitator was the ability to establish working relationships with private sector vendors and contractors to rapidly procure and manufacture necessary supplies locally. NYC residents were, on average, less than 25 min away from free SARS-CoV-2 diagnostic testing services by public transport, and services were successfully directed to most neighborhoods with the highest transmission rates, with only one notable exception. A key feature was to direct mobile testing vans and rapid antigen testing services to areas based on real-time neighborhood transmission data. Municipal leaders should prioritize fortifying supply chains, establish cross-sectoral partnerships to support and extend testing services, plan for continuous testing and validation of assays, ensure open communication feedback loops with CBO partners, and maintain infrastructure to support mobile services during infectious disease emergencies.

Impact of Neighborhood Social Cohesion and Rodent Sightings on Mental Health among Residents of New York City During the COVID-19 Pandemic.

Common mental disorders such as depression and anxiety are prevalent globally, and rates are especially high in New York City (NYC) since the COVID-19 pandemic. Neighborhood social and physical environments have been found to influence mental health. We investigated the impact of neighborhood social cohesion and neighborhood rodent sightings (as an indicator of neighborhood cleanliness) on nonspecific serious psychological distress (NSPD) status using 2020 NYC Community Health Survey data from 8781 NYC residents. Multivariable logistic regression was used to evaluate the relationships among social cohesion, rodent sightings, and NSPD adjusted for confounders and complex sampling and weighted to the NYC population. Effect measure modification of rodent sightings on the effect of social cohesion on NSPD was evaluated on the multiplicative scale by adding the interaction term to the multivariable model and, if significant, stratifying on the effect modifier, and on the additive scale using the relative excess risk due to interaction (RERI). Social cohesion was found to decrease the odds of NSPD, and rodent sightings were found to increase the odds of NSPD. We found significant evidence of effect measure modification on the multiplicative scale. In the stratified models, there was a protective effect of social cohesion against NSPD among those not reporting rodent sightings, but no effect among those reporting rodent sightings. Our findings suggest that both neighborhood social cohesion and rodent sightings impact the mental health of New Yorkers and that rodent infestations may diminish the benefit of neighborhood social cohesion.

Assessing New York City's COVID-19 Vaccine Rollout Strategy: A Case for Risk-Informed Distribution.

This study reviews the impact of eligibility policies in the early rollout of the COVID-19 vaccine on coverage and probable outcomes, with a focus on New York City. We conducted a retrospective ecological study assessing age 65+, area-level income, vaccination coverage, and COVID-19 mortality rates, using linked Census Bureau data and New York City Health administrative data aggregated at the level of modified zip code tabulation areas (MODZCTA). The population for this study was all individuals in 177 MODZCTA in New York City. Population data were obtained from Census Bureau and New York City Health administrative data. The total mortality rate was examined through an ordinary least squares (OLS) regression model, using area-level wealth, the proportion of the population aged 65 and above, and the vaccination rate among this age group as predictors. Low-income areas with high proportions of older people demonstrated lower coverage rates (mean vaccination rate 52.8%; maximum coverage 67.9%) than wealthier areas (mean vaccination rate 74.6%; maximum coverage 99% in the wealthiest quintile) in the first 3 months of vaccine rollout and higher mortality over the year. Despite vaccine shortages, many younger people accessed vaccines ahead of schedule, particularly in high-income areas (mean coverage rate 60% among those 45-64 years in the wealthiest quintile). A vaccine program that prioritized those at greatest risk of COVID-19-associated morbidity and mortality would have prevented more deaths than the strategy that was implemented. When rolling out a new vaccine, policymakers must account for local contexts and conditions of high-risk population groups. If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower.

A multisector community-engaged collaborative for mental health integration in primary care and housing developments: Protocol for a stepped-wedge randomized controlled trial (the Harlem Strong Program).

BACKGROUND: Addressing mental health disparities following COVID-19 requires adaptive, multi-sectoral, equity-focused, and community-based approaches. Mental health task-sharing in gateway settings has been found to address mental health care gaps in low- and middle-income countries, but is not a common practice in the U.S., especially in non-medical settings, such as low-income housing developments (LIH). This research study will evaluate the effectiveness of a multisectoral community-engaged collaborative for task-sharing mental health care on consumer, provider, and implementation outcomes, as well as identify barriers and facilitators for implementation. METHODS: In this stepped-wedge randomized controlled trial with technology supplementation, LIH and primary care sites will be randomly assigned to one of five sequences of three implementation strategies: (1) Education and Resources (E&R), which involves online training and resources on basic mental health task-sharing skills, (2) Multisectoral Community Collaborative Care (MCC), which consists of all E&R resources plus additional community responsive implementation supports and participation in a multisectoral coalition and (3) MCC + Technology, which combines the MCC condition resources with a community crowdsourced technology solution to support implementation. The primary outcome is the effectiveness in meeting consumers' needs through direct service (e.g., adequately addressing depression and anxiety symptoms), and through implementation to increase access to mental health care (reach). The secondary outcome examines additional consumer outcomes including health functioning and social risks, as well as implementation outcomes including provider skills, program adoption, and factors related to barriers and facilitators of quality implementation. A total of 700 consumers receiving mental health care at 20 sites will be surveyed at baseline, 6-, and 12-month follow-ups. Additionally, 100 providers will be evaluated at baseline, 6-, 12-, and 24-month follow-ups before training and after randomization. DISCUSSION: We hypothesize that MCC and MCC + Technology conditions will demonstrate significantly higher efficacy in changing primary outcomes compared to E&R, and the MCC + Technology supplement will show significantly higher levels of reach of mental health tasks compared to the MCC condition alone. These findings will demonstrate the feasibility of mental health integration into accessible, non-medical community settings such as LIH. Moreover, it will help establish a multilevel system solution based on community engagement and planning with a multisectoral collaboration that can be sustained community-wide. TRIAL REGISTRATION: NCT05833555 on Clinicaltrials.gov. Registered April 26, 2023.

Social and Demographic Influences of Trust in Cancer Information Among Brooklyn, New York Residents.

Little is known regarding the patterns of trust sources for cancer information among diverse populations in the US, which is particularly poignant during the current era of misinformation. Our objective to assess trust from different sources among a sample of Brooklyn, New York residents. Using data from the NCI funded Brooklyn Cancer Health Impact Program, we examined HINTS validated questions examining trust in cancer information across 9 sources. Logistic regression models were used to examine associations with cancer information trust sources. For trust in government health agencies, participants who had less than a college degree were almost 30% less likely to report high levels of trust (aOR: 0.71; 95% CI: 0.52-0.98), participants who reported a household income under $50,000 were 35% less likely report high levels of trust (aOR: 0.65; 95% CI: 0.47-0.89). Participants whose primary language was Spanish were significantly less likely to trust government (aOR: 0.45; 95% CI: 0.29-0.70), newspapers and magazines (aOR: 0.54; 95% CI, 0.34-0.84), and charitable organizations (aOR: 0.48; 95% CI, 0.31-0.75) compared to participants whose primary was English. New York is the most populous city in the US, a city of immigrants, and it is important for healthcare and public health professionals to explore how they can utilize media to provide accurate scientific evidence to combat cancer misinformation.

Mental Health Service Use, Barriers, and Service Preferences During COVID-19 among Low-Income Housing and Market-Rate Housing Residents of Harlem in New York City.

This study examined the differences in mental health service use, barriers, and service preferences among 393 low-income housing (LIH) and market-rate housing (MRH) Harlem residents in New York City. One-third (34.6%) endorsed the need for professional support for psychological issues, 27.2% and 15.8% reported using counseling services and psychotropic medication, with no differences between housing types. LIH residents (21.6-38.8%) reported significantly higher use of all types of mental health resources (e.g., websites, anonymous hotlines, self-help tools) compared with MRH residents (16.1-26.4%). Eighty-six percent reported barriers to mental health access, with LIH residents reporting more than double the barriers. Particularly, LIH residents reported greater difficulty getting time off work (34.1% vs. 14%), lack of health insurance (18.7% vs. 9.8%), lack of trust in mental health providers (14.6% vs. 4.7%), and stigma (12.2% vs. 5.1%) compared with MRH residents. Residents most preferred places of services were health clinics and houses of worship; provided by healthcare and mental health providers; and services delivered in-person and phone-based counseling. In contrast, residents least preferred getting support at mental health clinics; from family/friends; and by the Internet. No differences were found between service preferences by housing type. LIH residents reported higher use of mental health services and resources, but they face significantly more barriers to mental health care, suggesting a need to address specific barriers. Preferences for mental health services suggest a need for expanding mental health services to different settings given the low preference for services to be delivered at mental health clinics.

Delayed Recognition of Coronavirus Disease 2019 (COVID-19) in New York City: A Descriptive Analysis of COVID-19 Illness Prior to 29 February 2020.

BACKGROUND: On 30 January 2020, COVID-19 was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization. Almost a month later, on 29 February 2020, the first case in New York City (NYC) was diagnosed. METHODS: Three hundred sixty persons with COVID-19-like illness were reported to the NYC Department of Health and Mental Hygiene (DOHMH) before 29 February, but 37 of these tested negative and 237 were never tested for severe acute respiratory syndrome coronavirus 2. Records of 86 persons with confirmed COVID-19 and reported symptom onset prior to 29 February 2020 were reviewed by 4 physician-epidemiologists. Case-patients were classified as possible delayed recognition (PDR) of COVID-19 when upon medical review the reported onset date was believed to reflect the initial symptoms of COVID-19, or insufficient evidence to classify, when the onset could not be determined with confidence. Clinical and epidemiological factors collected by DOHMH and supplemented with emergency department records were analyzed. RESULTS: Thirty-nine PDR COVID-19 cases were identified. The majority had severe disease with 69% presenting to an emergency department within 2 weeks of symptom onset. The first PDR COVID-19 case had symptom onset on 28 January 2020. Only 7 of the 39 cases (18%) had traveled internationally within 14 days of onset (none to China). CONCLUSIONS: COVID-19 was in NYC before being classified as a PHEIC, and eluded surveillance for another month. The delay in recognition limited mitigation efforts; by the time city- and statewide mandates were enacted, 16 and 22 days later, there was already widespread community transmission.

Racial and Socioeconomic Equity of Tecovirimat Treatment during the 2022 Mpox Emergency, New York, New York, USA.

We assessed tecovirimat treatment equity for 3,740 mpox patients in New York, New York, USA, during the 2022 mpox emergency; 32.4% received tecovirimat. Treatment rates by race/ethnicity were 38.8% (White), 31.3% (Black/African American), 31.0% (Hispanic/Latino), and 30.1% (Asian/Pacific Islander/other). Future public health emergency responses must prioritize institutional and structural racism mitigation.

Field Testing the "Avoid the Needle" Intervention for Persons at Risk for Transitioning to Injecting Drug Use in Tallinn, Estonia and New York City, USA.

This study aimed to field tested the "Avoid the Needle" (AtN) intervention to reduce transitions from non-injecting to injecting drug use in two different epidemiological settings. Respondent driven sampling was used to recruit current non-injecting drug users (NIDUs) in Tallinn, Estonia in 2018-19 and in New York City (NYC) in 2019-20. Both persons who had never injected and persons who had previously injected but not in the last 6 months were eligible; a structured interview was administered, a blood sample collected, and the intervention administered by trained interventionists. We recruited 19 non-injectors from Tallinn and 140 from NYC. Participants in Tallinn were younger and had begun using drugs at earlier ages than participants in NYC. The primary drugs used in Tallinn were amphetamine, fentanyl, and opioid analgesics, while in NYC they were heroin, cocaine, speedball, and fentanyl. Six-month follow-up data were obtained from 95% of participants in Tallinn. The study was interrupted by COVID-19 lockdown in NYC, but follow-up data were obtained from 59% of participants. There were minimal transitions to injecting: 1/18 in Tallinn and 0/83 in NYC. There were significant declines in the frequencies of using readily injectable drugs (fentanyl, amphetamine, heroin, cocaine) from baseline to follow-up in both sites (Cochran-Armitage tests for trend, χ2 = 21.3, p < 0.001 for New York City; and χ2 = 3.9, p = 0.048 for Tallinn). Reducing transitions into injecting is a potentially very important method for reducing HIV transmission and other harms of drug use. Further investigation and implementation of AtN type interventions is warranted.

Alcohol Misuse, Binge Drinking, and their Associations with Psychosocial Factors during COVID-19 among Harlem Residents in New York City.

This study examined alcohol misuse and binge drinking prevalence among Harlem residents, in New York City, and their associations with psycho-social factors such as substance use, depression symptom severity, and perception of community policing during COVID-19. An online cross-sectional study was conducted among 398 adult residents between April and September 2021. Participants with a score of at least 3 for females or at least 4 for males out of 12 on the Alcohol Use Disorders Identification Test were considered to have alcohol misuse. Binge drinking was defined as self-reporting having six or more drinks on one occasion. Modified Poisson regression models were used to examine associations. Results showed that 42.7% used alcohol before COVID-19, 69.1% used it during COVID-19, with 39% initiating or increasing alcohol use during COVID-19. Alcohol misuse and binge drinking prevalence during COVID-19 were 52.3% and 57.0%, respectively. Higher severity of depression symptomatology, history of drug use and smoking cigarettes, and experiencing housing insecurity were positively associated with both alcohol misuse and binge drinking. Lower satisfaction with community policing was only associated with alcohol misuse, while no significant associations were found between employment insecurity and food insecurity with alcohol misuse or binge drinking. The findings suggest that Harlem residents may have resorted to alcohol use as a coping mechanism to deal with the impacts of depression and social stressors during COVID-19. To mitigate alcohol misuse, improving access to mental health and substance use disorder services, and addressing public safety through improving relations with police could be beneficial.

Reflections on the New York City Health Czar Proposal of 1977 and Its Origins.

New York City's fiscal crisis of 1975 was the result of many years of deficit spending to support a variety of expanded services and generous union contracts. These deficits were covered for years by the issuance of city short-term notes and long-term bonds. Eventually, the city's mounting debt of $14 billion led to its inability to sell its notes and bonds. In order to deal with the possibility of the city's financial collapse, the governor of New York State and the state legislature created the Emergency Financial Control Board (EFCB), whose purpose was to manage the city's budget and cost reduction plans. They also created the Municipal Assistance Corporation (MAC) responsible for fiscal oversight and the sale of specially issued bonds. Both agencies eventually played major roles in preventing the city's financial collapse. In an effort to address the costly 5,000 excess acute care hospital beds in the city, the governor and his advisors proposed the creation of a Health Czar (HC). The purpose of this position was to shift responsibility for hospital closures and downsizing from the state government to a para-governmental individual. While there was early support for this proposal by some print media, opposition soon arose because of the flawed structure of the proposal. Also, many initially opposed it because it included the city's public health agency, the New York City Department of Health (NYCDOH), which did not have any responsibility for hospitals. The HC proposal eventually lost broad support because it bypassed legally established processes for the oversight of hospitals. It also almost uniquely focused on the public hospital system, and in so doing gave a pass to the voluntary hospitals and their excess bed capacities. The proposal eventually lost the support of the then mayor when the governor publicly supported a rival candidate in an upcoming election. The election success of yet a third candidate opposed to the proposal resulted in its eventual abandonment by the governor.

Micromobility Vehicles, Obstructions, and Rider Safety Behaviors in New York City Bike Lanes.

Micromobility vehicles (MMVs) have become increasingly popular, particularly in urban areas where infrastructure has improved in recent years to facilitate their use. The purpose of this study was to observe protected bike lanes in 10 zones of Manhattan, NYC to: (1) describe the MMVs in bike lanes by type, phone and helmet use; and (2) document MMV users' responses to obstructions. Approximately 1 in 4 of all riders (260/998) were wearing a helmet. Fewer than 2% were observed using a phone while moving. Fewer than 9% of Citi Bike users were wearing a helmet. In contrast, over one-third of non-Citi Bike users were wearing a helmet (228 of 670, 34.03%). This difference was determined to be significant by a chi-squared test (a = 0.05) with a p-value less than 0.0001. Of the 988 MMVs observed in this study, 398 (40.28%) were motorized and 590 (59.72%) were non-motorized. A similar proportion of users of motorized riders versus non-motorized vehicles were wearing a helmet (28.14%, 112/398 versus 24.41%, 144/590). A total of 232 riders (23.50%) encountered an obstruction in their bike lane. Of these obstructions in a bike lane, 82.33% (191/232) were a car/vehicle and 17.67% (41/232) was garbage. A large majority of riders (87.93%) reacted by riding into the traffic lane. These findings suggest that further research and local education, enforcement, and legislative efforts are needed to examine and implement best practices in the safe operation of MMVs, decreasing bike lane obstructions, promoting helmet use, and raising awareness of MMV legislation.

Substance Use Patterns and Their Association with Depression and Social Factors During COVID-19 Among Harlem Residents in New York City.

This study aimed to identify the prevalence of substance use before and during COVID-19; and examined its association with depression and social factors among 437 residents from the neighborhood of Harlem in Northern Manhattan, New York City. Over a third of respondents reported using any substance before COVID-19, and initiating/increasing substance use during COVID-19. The most common substances used before COVID-19 and initiated/increased during COVID-19 were smoking (20.8% vs. 18.3%), marijuana (18.8% vs. 15.3%), and vaping (14.2% and 11.4%). The percentages of any hard drug use were 7.3% and 3.4%, respectively. After adjustment, residents with mild (Prevalence Ratio [PR] = 2.86, 95% CI 1.65, 4.92) and moderate (PR = 3.21, 95% CI 1.86, 5.56) symptoms of depression, and housing insecurity (PR = 1.47, 95% CI 1.12, 1.91) had at least a 47% greater probability of initiating and/or increasing substance use. Conversely, respondents with employment insecurity (PR = 0.71, 95% CI 0.57, 0.88) were 29% less likely to report such patterns. No association was found between substance use initiation and/or increase and food insecurity. High prevalence of substance use during COVID-19 may lead residents to turn to substance use as a coping mechanism for psychosocial stressors. Thus, it is essential to provide accessible and culturally sensitive mental health and substance use services.

Addressing Financial Barriers to Health Care Among People Who are Low-Income and Insured in New York City, 2014-2017.

While health care-associated financial burdens among uninsured individuals are well described, few studies have systematically characterized the array of financial and logistical complications faced by insured individuals with low household incomes. In this mixed methods paper, we conducted 6 focus groups with a total of 55 residents and analyzed programmatic administrative records to characterize the specific financial and logistic barriers faced by residents living in public housing in East and Central Harlem, New York City (NYC). Participants included individuals who enrolled in a municipal community health worker (CHW) program designed to close equity gaps in health and social outcomes. Dedicated health advocates (HAs) were explicitly paired with CHWs to provide health insurance and health care navigational assistance. We describe the needs of 150 residents with reported financial barriers to care, as well as the navigational and advocacy strategies taken by HAs to address them. Finally, we outline state-level policy recommendations to help ameliorate the problems experienced by participants. The model of paired CHW-HAs may be helpful in addressing financial barriers for insured populations with low household income and reducing health disparities in other communities.

Racial/ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City.

INTRODUCTION: We evaluated racial/ethnic differences in the receipt of naloxone distributed by opioid overdose prevention programs (OOPPs) in New York City (NYC). METHODS: We used naloxone recipient racial/ethnic data collected by OOPPs from April 2018 to March 2019. We aggregated quarterly neighborhood-specific rates of naloxone receipt and other covariates to 42 NYC neighborhoods. We used a multilevel negative binomial regression model to assess the relationship between neighborhood-specific naloxone receipt rates and race/ethnicity. Race/ethnicity was stratified into four mutually exclusive groups: Latino, non-Latino Black, non-Latino White, and non-Latino Other. We also conducted racial/ethnic-specific geospatial analyses to assess whether there was within-group geographic variation in naloxone receipt rates for each racial/ethnic group. RESULTS: Non-Latino Black residents had the highest median quarterly naloxone receipt rate of 41.8 per 100,000 residents, followed by Latino residents (22.0 per 100,000), non-Latino White (13.6 per 100,000) and non-Latino Other residents (13.3 per 100,000). In our multivariable analysis, compared with non-Latino White residents, non-Latino Black residents had a significantly higher receipt rate, and non-Latino Other residents had a significantly lower receipt rate. In the geospatial analyses, both Latino and non-Latino Black residents had the most within-group geographic variation in naloxone receipt rates compared to non-Latino White and Other residents. CONCLUSIONS: This study found significant racial/ethnic differences in naloxone receipt from NYC OOPPs. We observed substantial variation in naloxone receipt for non-Latino Black and Latino residents across neighborhoods, indicating relatively poorer access in some neighborhoods and opportunities for new approaches to address geographic and structural barriers in these locations.

COVID-19 vaccination and HIV transmission among persons who inject drugs during the first two years of the COVID-19 pandemic in New York City.

BACKGROUND: To examine COVID-19 vaccination and HIV transmission among persons who inject drugs (PWID) during the COVID-19 pandemic (2020-2022) in New York City (NYC). METHODS: Two hundred and seventy five PWID were recruited from October 2021 to September 2022. A structured questionnaire was used to measure demographics, drug use behaviors, overdose experiences, substance use treatment history, COVID-19 infection, vaccination, and attitudes. Serum samples were collected for HIV, HCV, and SARS-CoV-2 (COVID-19) antibody testing. RESULTS: Participants were: 71% male, the mean age was 49 (SD 11), 81% reported at least one COVID-19 immunization, 76% were fully vaccinated and 64% of the unvaccinated had antibodies for COVID-19. Self-reported injection risk behaviors were very low. HIV seroprevalence was 7%. Eighty-nine percent of the HIV seropositive respondents reported knowing they were HIV seropositive and being on antiretroviral therapy prior to the COVID-19 pandemic. There were two likely seroconversions in 518.83 person-years at risk from the March 2020 start of the pandemic to the times of interviews, for an estimated incidence rate of 0.39/100 person-years, 95% Poisson CI 0.05-1.39/100 person-years. CONCLUSIONS: There is concern that the COVID-19 pandemic disruptions to HIV prevention services and the psychological stress of the pandemic may lead to increased risk behavior and increased HIV transmission. These data indicate adaptive/resilient behaviors in both obtaining COVID-19 vaccination and maintaining a low rate of HIV transmission among this sample of PWID during the first two years of the COVID-19 pandemic in NYC.

Investigation of a river-tunnel effect on PM2.5 concentrations in New York City subway stations.

It is well-documented that subway stations exhibit high fine particulate matter (PM2.5) concentrations. Little is known about the potential of river-tunnels to increase PM2.5 concentrations in subways. We hypothesized a "river-tunnel" effect exists: Stations adjacent to poorly ventilated tunnels that travel beneath rivers exhibit higher PM2.5 concentrations than more distant stations. Accordingly, the PM2.5 concentrations were monitored at stations adjacent to and two- and three-stations distant from the river-tunnel. Multivariate linear regression analysis was conducted to disentangle how proximity to a river-tunnel and other factors (e.g., depth) influence concentrations. Stations adjacent to a river-tunnel had 80-130% higher PM2.5 concentrations than more distant stations. Moreover, distance from a river-tunnel was the strongest PM2.5-influencing factor This distance effect was not observed at underground stations adjacent to a river-bridge. The "river-tunnel" effect explains some of the inter-station variability in subway PM2.5 concentrations. These results support the need for improving ventilation systems in subways.

"Like pouring salt in a wound": A qualitative exploration of the consequences of unmet housing needs for cancer patients and survivors in New York City.

OBJECTIVE: To identify consequences of unmet housing needs in the period following cancer diagnosis. DESIGN: Qualitative descriptive design. PARTICIPANTS: New York City-based cancer patients and survivors (n = 21) who reported experience of unmet housing needs while receiving cancer treatment. Key informants (n = 9) with relevant expertise (e.g. oncology social workers). METHODS: One-time semi-structured telephone or in-person interviews were conducted with all participants. Inductive thematic coding was conducted using a pragmatic paradigm. FINDINGS: Four categories of consequences emerged: 1) cancer management and health (rest and recovery, illness/injury risk, medical care); 2) psychological (stress and anxiety, lack of control and independence, self-esteem/pride, sadness/depression, cancer coping); 3) social (relationships, consequences for others, isolation); and 4) standard of functional living. CONCLUSION: The simultaneous experience of cancer and unmet housing needs is broadly burdensome. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS: Screening and resources for addressing unmet housing needs must be prioritized to holistically care for patients.