Preliminary outcomes for a housing placement intervention for HIV-positive homeless individuals living in New York City
The Enhanced Housing Placement Assistance (EHPA) Study is a randomized controlled trial of a housing placement program for persons living with HIV/AIDS (PLWHA) residing in the New York City (NYC) HIV emergency shelter system.
Study participants (N=236) were randomized to EHPA (housing placement with a case manager working with clients wherever they are living, including one year after housing placement) or usual care (UC, referral to housing placement programs). Baseline assessments were conducted using standard instruments. Housing placement at 6-months was assessed using confirmed housing data. Viral suppression was defined as having ≥1 suppressed viral load (VL) test result (≤200 copies/mL) and no 2 consecutive unsuppressed results during 6 months follow-up and assessed using data from the NYC HIV Surveillance Registry. Differences in the proportion of individuals housed at 6-months follow-up were assessed using chi-square tests. Intent-to-treat analysis using logistic regression was used to compare differences between EHPA and UC participants in housing placement and viral suppression at 6 months follow-up. Age, race/ethnicity, sex, and receipt of Social Security payments were included as predictors.
Participants enrolled in EHPA were more likely to have been housed at 6 months follow-up compared to UC (aOR 1.89, 95%CI 1.00, 3.54). Proportion with viral suppression over 6 months was 52% overall; there were no differences in viral suppression between the two groups.
These preliminary findings suggest that timely placement of homeless PLWHA into stable housing may be related to providing comprehensive case management services to clients wherever they are living.
Learning Areas:Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Public health or related research
Social and behavioral sciences
Describe the characteristics of homeless persons living with HIV in New York City. Explain differences in housing and HIV health care outcomes among homeless persons living with HIV in New York City enrolled in an enhanced housing placement program intervention, versus usual care. Discuss challenges and best practices in design and evaluation of programs intended to enhance housing stability and engagement in HIV health care, among homeless persons living with HIV.
Keyword(s): HIV/AIDS, Homelessness
Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple federally funded grants focusing on addressing homelessness and substance abuse among homeless persons living with HIV/AIDS (PLWHA). My research has focused on understanding psychological, social and contextual predictors of HIV risk behaviors among those at high-risk of infection, as well as clinical and housing stability outcomes among homeless PLWHA. I am the principal for the study described in this abstract.
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.