Background: The transient lives of homeless individuals complicate prospective studies of their needs and behaviors. We studied the relationship between homelessness, risky behaviors and HIV infection in an ongoing study of IDUs which began in Baltimore, MD, in 1988-89.
Hypothesis: During periods of homelessness, participants are more likely to engage in high-risk behaviors, which are also known risk factors for HIV seroconversion.
Method: IDUs underwent HIV tests and semi-annual questionnaires regarding their sexual and drug use behaviors and indicated whether they had been homeless in the prior 6 months. Logistic regression using generalized estimating equations was used to identify factors associated with homelessness at each visit from 1988-2000, adjusting for time and year of entry into the cohort.
Results: 2427 subjects contributed 22326 observations, 76% were male, 93% were African American; mean age was 34 years. 1141 (47%) had experienced homelessness at least once during the follow up period. Independent predictors of homelessness included: younger age (OR 1.23, 95% CI 1.14-1.31), being male (OR 1.60, 95% CI 1.43 – 1.82), single, injecting illicit drugs, using shooting galleries (OR 1.55, 95% CI 1.35 – 1.79), sharing injection equipment, trading sex for money or food (OR 1.26, 95% CI 1.12 – 1.41), engaging in homosexual activity, having a recent STD and being HIV positive (OR 1.26, 95% CI 1.21 –1.43)
Conclusion: During times of homelessness there is a greater likelihood of engaging in high-risk behaviors, that are also risk factors for HIV seroconversion. This has important health care, policy and public health implications.
Learning Objectives: N/A
Keywords: Homelessness, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.