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Viral suppression during COVID-19 among people with HIV experiencing homelessness in a low-barrier clinic-based

Matthew D Hickey1, Elizabeth Imbert1, David V Glidden2

  • 1Division of HIV, ID and Global Medicine, University of California, San Francisco.

AIDS (London, England)
|December 11, 2020
PubMed

Insights

The COVID-19 pandemic did not negatively impact HIV care engagement or viral suppression for homeless individuals in a low-barrier program. Maintaining in-person HIV services is crucial for this vulnerable population.

Area of Science:

  • Public Health
  • Infectious Diseases
  • HIV Medicine

Background:

  • Coronavirus disease-2019 (COVID-19) poses a significant risk to HIV outcomes, particularly for individuals experiencing homelessness.
  • The intersection of homelessness and HIV presents unique challenges in maintaining consistent healthcare access and treatment adherence.

Purpose of the Study:

  • To evaluate the impact of the COVID-19 pandemic and associated public health measures on HIV care engagement and viral suppression among unhoused individuals.
  • To assess the effectiveness of a low-barrier, high-intensity HIV primary care program ('POP-UP') in maintaining health outcomes during the pandemic.

Main Methods:

  • An interrupted time-series analysis was employed to examine trends in care engagement and viral suppression.
  • Data were collected from 85 unhoused patients enrolled in the 'POP-UP' HIV primary care program.
  • The analysis focused on the period before and after the implementation of San Francisco's 'shelter-in-place' ordinance.

Main Results:

  • Care engagement among unhoused patients remained stable in the 5 months following the 'shelter-in-place' order.
  • Viral suppression rates among the study population did not decrease during the observed period.
  • The 'POP-UP' program demonstrated resilience in maintaining critical HIV care metrics.

Conclusions:

  • Low-barrier, in-person HIV primary care is vital for sustaining HIV outcomes in homeless populations during public health crises like the COVID-19 pandemic.
  • The findings underscore the importance of accessible and consistent healthcare services for vulnerable groups.
  • The 'POP-UP' model provides a potential framework for effective HIV management in challenging circumstances.

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