nach oben

Erschienen in:

01.06.2010 | Original Paper

Randomized Trial of the Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living with HIV

verfasst von: Richard J. Wolitski, Daniel P. Kidder, Sherri L. Pals, Scott Royal, Angela Aidala, Ron Stall, David R. Holtgrave, David Harre, Cari Courtenay-Quirk, for the Housing and Health Study Team

Erschienen in: AIDS and Behavior | Ausgabe 3/2010

Einloggen, um Zugang zu erhalten

Abstract

Homelessness affects HIV risk and health, but little is known about the longitudinal effects of rental assistance on the housing status and health of homeless and unstably housed people living with HIV/AIDS. Homeless/unstably housed people living with HIV/AIDS (N = 630) were randomly assigned to immediate Housing Opportunities for People with AIDS (HOPWA) rental assistance or customary care. Self-reported data, CD4, and HIV viral load were collected at baseline, 6, 12, and 18 months. Results showed that housing status improved in both groups, with greater improvement occurring in the treatment group. At 18 months, 51% of the comparison group had their own housing, limiting statistical power. Intent-to-treat analyses demonstrated significant reductions in medical care utilization and improvements in self-reported physical and mental health; significant differential change benefiting the treatment group was observed for depression and perceived stress. Significant differences between homeless and stably housed participants were found in as-treated analyses for health care utilization, mental health, and physical health. HOPWA rental assistance improves housing status and, in some cases, health outcomes of homeless and unstably housed people living with HIV/AIDS.

Krieger J, Higgins D. Housing and health: time again for public health action. Am J Public Health. 2002;92:758–68.CrossRefPubMed

Martens WH. A review of physical and mental health in homeless persons. Public Health Rev. 2001;29:13–33.PubMed

Institute of Medicine. Homelessness, health and human needs. Washington, DC: National Academy Press, Institute of Medicine; 1988.

Shaw M. Housing and public health. Ann Rev Public Health. 2004;25:397–418.CrossRef

Hwang SW, Tolomiczenko G, Kouyoumdjian FG, Garner RE. Interventions to improve the health of the homeless: a systematic review. Am J Prev Med. 2005;29:311–9.CrossRefPubMed

Wolitski RJ, Kidder DP, Fenton KA. HIV, homelessness, and public health: Critical issues and a call for increased action. AIDS Behav. 2007;11(6 Supp):167–71.CrossRefPubMed

Aidala AA, Sumartojo E. Why housing? AIDS Behav. 2007;11(6 Supp):1–6.CrossRefPubMed

Allen DM, Lehmn S, Green TA, et al. HIV infection among homeless adults and runaway youth, United States, 1989–1992. AIDS. 1994;8:1593–8.CrossRefPubMed

Culhane DP, Gollub E, Kuhn R, Shapner M. The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilization in Philadelphia. J Epidemiol Community Health. 2001;55:515–20.CrossRefPubMed

10.

Estebanez PE, Russell NK, Aguilar MD, Beland F, Zunzunegui MV. Women, drugs and HIV/AIDS: results of a multicentre European study. Intl J Epidemiol. 2000;29:734–43.CrossRef

11.

Zolopa AR, Hahn JA, Gorter R, et al. HIV and tuberculosis infection in San Francisco’s homeless adults—prevalence and risk factors in a representative sample. JAMA. 1994;272:455–61.CrossRefPubMed

12.

Kidder DP, Wolitski RJ, Campsmith ML, Nakamura GV. Health status, health care use, and medication adherence in homeless and housed people living with HIV. Am J Public Health. 2007;97:2238–45.CrossRefPubMed

13.

Leaver CA, Bargh G, Dunn JR, Hwang SW. The effects of housing status on health-related outcomes in people living with HIV: a systematic review of the literature. AIDS Behav. 2007;11(6 Supp):85–100.CrossRefPubMed

14.

Smith MY, Rapkin BD, Winkel G, Springer C, Chahabra R, Feldman IS. Housing status and health care service utilization among low-income persons with HIV/AIDS. J Gen Intern Med. 2000;15:731–8.CrossRefPubMed

15.

Aidala AA, Lee G, Abramson DM, Messeri P, Siegler A. Housing need, housing assistance, and connection to HIV medical care. AIDS Behav. 2007;11(6 Supp):101–15.CrossRefPubMed

16.

Royal SW, Kidder DP, Parabansh S, et al. Factors associated with adherence to highly active antiretroviral therapy in homeless and unstably housed adults living with HIV. AIDS Care. 2009;21:448–55.CrossRefPubMed

17.

Kidder DP, Wolitski RJ, Pals SL, Campsmith ML. Housing status and HIV risk behaviors among homeless and unstably housed persons with HIV. J Acquir Immune Defic. 2008;49:451–5.CrossRef

18.

Aidala A, Cross JE, Stall R, Harre D, Sumartojo E. Housing status and HIV risk behaviors: Implications for prevention and policy. AIDS Behav. 2005;9:251–65.CrossRefPubMed

19.

Metraux S, Metzger DS, Culhane DP. Homelessness and HIV risk behaviors among injection drug users. J Urban Health. 2004;81:618–29.PubMed

20.

Friedman MS, Marshal MP, Stall R, et al. Associations between substance use, sexual risk taking and HIV treatment adherence among homeless people living with HIV. AIDS Care. 2009;21:692–700.CrossRefPubMed

21.

Coady MH, Latka MH, Thiede H, et al. Housing status and associated differences in HIV risk behaviors among young injection drug users (IDUs). AIDS Behav. 2007;11:854–63.CrossRefPubMed

22.

Wenzel SL, Tucker JS, Elliott MN, Hambarsoomians K. Sexual risk among impoverished women: Understanding the role of housing status. AIDS Behav. 2007;11(6 Supp):9–20.CrossRefPubMed

23.

Kidder DP, Wolitski RJ, Royal S, et al. Access to housing as a structural intervention for homeless and unstably housed people living with HIV: rationale, methods, and implementation of the housing and health study. AIDS Behav. 2007;11(6 suppl):149–61.CrossRefPubMed

24.

Kamb ML, Fishbein M, Douglas JM, et al. Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases—a randomized controlled trial. JAMA. 1998;280:1161–7.CrossRefPubMed

25.

DHHS Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. Bethesda, MD: National Institutes of Health; 2006. Available at: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentsGL.pdf. Accessed April 24, 2007.

26.

Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10:77–84.PubMed

27.

Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapam S, Oskamp S, editors. The social psychology of health: Claremont symposium on applied social psychology. Newbury Park: Sage; 1988.

28.

Ware JE, Kosinski M, Dewey JE. How to score version 2 of the SF-36^® Health Survey. Lincoln, RI: QualityMetric Inc.; 2000.

29.

Wolitski RJ, Parsons JT, Gomez CA, et al. Prevention with gay and bisexual men living with HIV: rationale and methods of the Seropositive Urban Men’s Intervention Trial (SUMIT). AIDS. 2005;19(suppl 1):S1–11.CrossRefPubMed

30.

Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.CrossRef

31.

SAS Institute. SAS/STAT software for PC (version 9.1). Carey, NC: SAS Institute; 2003.

32.

West SG, Duan N, Pequegnat W, et al. Alternatives to the randomized controlled trial. Am J Public Health. 2008;98:1359–66.CrossRefPubMed

33.

Stein JA, Gelberg L. Comparability and representativeness of clinical homeless, community homeless, and domiciled clinic samples: physical and mental health, substance use, and health service utilization. Health Psychol. 1997;16:155–62.CrossRefPubMed

34.

Wong YL, Piliavin I. Stressors, resources, and distress among homeless persons: a longitudinal analysis. Soc Sci Med. 2001;52:1029–42.CrossRefPubMed

35.

Lyles CM, Kay LS, Crepaz N, et al. Best-evidence interventions: findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000–2004. Am J Public Health. 2007;97:133–43.CrossRefPubMed

36.

Shubert V, Bernstine N. Moving from fact to policy: housing is HIV prevention and health care. AIDS Behav. 2007;11(6 Suppl):172–81.CrossRefPubMed

37.

Sadowski LS, Kee RA, VanderWeele TJ, Buchanan D. Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: a randomized trial. JAMA. 2009;301:1771–8.CrossRefPubMed

Titel: Randomized Trial of the Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living with HIV
verfasst von: Richard J. Wolitski
Daniel P. Kidder
Sherri L. Pals
Scott Royal
Angela Aidala
Ron Stall
David R. Holtgrave
David Harre
Cari Courtenay-Quirk
for the Housing and Health Study Team
Publikationsdatum: 01.06.2010
Verlag: Springer US
Erschienen in: AIDS and Behavior / Ausgabe 3/2010
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-009-9643-x

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

23.04.2024 | Ablationstherapie | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Randomized Trial of the Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living with HIV

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Hinter dieser Appendizitis steckte ein Erreger

Demenzkranke durch Antipsychotika vielfach gefährdet

Update Innere Medizin

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2010

Brief and Intensive Behavioral Interventions to Promote Sexual Risk Reduction among STD Clinic Patients: Results from a Randomized Controlled Trial

A Randomized Trial to Evaluate the Efficacy of a Computer-Tailored Intervention to Promote Safer Injection Practices Among Drug Users

Comparing Couples’ and Individual Voluntary Counseling and Testing for HIV at Antenatal Clinics in Tanzania: A Randomized Trial

Pilot Study Assessing HIV Vaccine Trial Readiness Among Female Sex Workers, Injection and Non-injection Drug Users, and Men Who Have Sex with Men in Spain

A Mixed Methods Evaluation of the Effect of the Protect and Respect Intervention on the Condom Use and Disclosure Practices of Women Living with HIV/AIDS

Acceptability and Use of the Diaphragm and Replens® Lubricant Gel for HIV Prevention in Southern Africa

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Hinter dieser Appendizitis steckte ein Erreger

Demenzkranke durch Antipsychotika vielfach gefährdet

Update Innere Medizin