Effect of supportive housing on CD4-cell count among homeless adults in supportive housing
METHODS: We used a nest case-cohort design to examine CD4-cell results for HIV positive adults who were placed in housing between 2007-2013. Triple-diagnosis was defined as an HIV diagnosis and co-occurring axis-1 mental health diagnosis and substance abuse or dependence. All those in the study received their diagnosis of HIV/AIDS before the DAH housing referral was made.
RESULTS: 15.4% of the individuals housed had HIV (n=243). 64% of HIV+ individuals had mental-health diagnoses; 74% had a substance abuse disorder and 49% had triple diagnoses. The average CD4 cell count one year before housing was 340 (SD: 234); after six months in housing the CD4 count was 371 (SD: 231), after twelve months it was 407 (SD: 209). Among triply diagnosed individuals placed in units with on-site nursing the mean CD4-cell count increased 53%.
DISCUSSION/CONCLUSION: It’s critical to acknowledge the difficulties that HIV-positive homeless patients with co-occurring illnesses face in getting and retaining care. Supportive housing should be prioritized towards homeless people with HIV to improve mortality and immune functioning. Placing triply diagnosed individuals in buildings with on-site nursing has a significant impact on CD4-cell count, presumably through improved adherence to anti-retroviral medication.
Learning Areas:Advocacy for health and health education
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related public policy
Describe the effect of a housing intervention on people living with HIV/AIDS; the learner will also be able to discuss the added positive effect of nursing for those with triple diagnoses.
Keyword(s): Homelessness, HIV/AIDS
Qualified on the content I am responsible for because: I am a research assistant for SFDPH, working on projects with Housing and Urban Health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.