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Homelessness, HIV, and Incomplete Viral Suppression
Kinna Thakarar1, Jake R Morgan2, Jessie M Gaeta3
1Section of Infectious Diseases, Boston Medical Center, Boston, MA.
Journal of Health Care for the Poor and Underserved
|August 17, 2016
Summary
Homelessness significantly increases the risk of incomplete HIV viral suppression. Stable housing and engagement with addiction services are crucial for improving treatment outcomes in HIV-positive individuals.
Area of Science:
- Public Health
- Infectious Diseases
- Health Disparities
Background:
- HIV viral suppression is critical for patient health and preventing transmission.
- Limited research exists on the impact of homelessness on achieving HIV viral suppression.
- Homeless individuals face unique challenges in managing chronic health conditions like HIV.
Purpose of the Study:
- To investigate the association between homelessness and HIV viral suppression.
- To identify factors contributing to incomplete viral suppression among HIV-positive patients in a Health Care for the Homeless program.
Main Methods:
- Analysis of electronic medical records for 138 HIV-seropositive patients in a Health Care for the Homeless (HCH) program.
- Comparison of demographic, health, and utilization characteristics based on housing status.
- Multivariable logistic regression to identify predictors of incomplete viral suppression in 95 patients with available viral load data.
Main Results:
- Homeless individuals were 3.84 times more likely to have incomplete HIV viral load suppression compared to housed individuals.
- Illicit drug use and the use of combined antiretroviral therapy (cART) were associated with achieving HIV viral suppression.
- Patient engagement with on-site addiction services may explain the association between drug use and viral suppression.
Conclusions:
- Homelessness is a significant predictor of incomplete HIV viral suppression.
- Stable housing interventions could improve viral suppression rates and access to cART.
- Integrated care models, including addiction services, are vital for managing HIV in vulnerable populations.
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