The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63700

Angela A. Aidala, PhD¹, Joyce Moon Howard, DrPH¹, Maria Caban, MA¹, and Jay E. Cross, PhD². (1) Center for Applied Public Health, Columbia University, 722 West 168th Street, Suite 1119, New York, NY 10032, 212-305-7023, aaa1@columbia.edu, (2) Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, Center for Applied Public Health, 722 West 168th Street, New York, NY 11553

Objectives: Homelessness and HIV complicate each other in ways that are not always understood. What are the service needs of homeless persons living with HIV/AIDS? What is the relationship between unstable housing and access to and engagement with HIV medical care? Do housing services make a difference?

Methods: Researchers pooled interview data from 3191 HIV positive clients presenting for services at agencies participating in a national, multi-site, evaluation study. Current housing status was coded as homeless, (sleeping on the street, public place, emergency shelter, n=1021), unstable (temporary housing program or doubled up with others, n=734), or stable (regular apartment or house, n=1436). Follow-up data collected 6 -9 months after baseline were available for 891 cases.

Results: Most homeless persons with HIV need more than housing: 45% screen positive for mental illness, 88% have a history of drug abuse, and 33% struggle with both problems. More than half report inadequate nutrition. The homeless are more likely than others to remain marginal to HIV medical care: 21% had no outpatient visits during the past 6-12 months and 44% received no HIV medications. They experienced more opportunistic infections and have lower self-rated health functioning. Housing services make a difference, especially when part of an integrated service model. Access to quality medical care and treatments and continuity of care over time significantly improved, as well as health outcomes.

Conclusions: Housing is health care for persons living with HIV/ AIDS.

Learning Objectives:

At the conclusion of the session, the participant will be able to:
• Specify the extent of homelessness and housing problems among persons living with HIV/AIDS in the U.S. today.
• Articulate the role of housing for access to medical care and treatments, adherence to treatments and health outcomes for persons living with HIV/AIDS.
• Prioritize service elements necessary for developing sucessful programs to improve medical care and health outcomes for HIV positive homelesss individuals and their families

Keywords: Housing, HIV/AIDS

Presenting author's disclosure statement:
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.