School of Medicine and Health Sciences Poster Presentations

Title

Examining how Housing Counseling Interventions Impact the Health Outcomes in Individuals with HIV in the DC area

Document Type

Poster

Abstract Category

HIV/AIDS

Keywords

Housing, HIV, DC

Publication Date

Spring 5-1-2019

Abstract

People living with HIV/AIDS have at least three times the rate of homelessness as the general population. In Washington, DC, 2% of residents are living with HIV, with 15.3% of them experiencing homelessness. The primary objective of this study is to provide a descriptive comparison of health markers for individuals who have a diagnosis of HIV and received a housing intervention from Housing Counseling Services (HCS). This is a retrospective study examining data from HCS databases and the HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA) surveillance databases.The health outcomes evaluated include viral suppression (VS) and retention in care (RIC). Proportions of individuals with VS and/or RIC were compared across client subgroups (sex, race/ethnicity, age, housing situation at time of intake, type of support received from HCS, e.g.) using chi-square or rank sum tests. Of 734 HCS participants matched to HAHSTA surveillance data, 621 (85%) had data available at intake to evaluate the VS outcome. The sample was predominately male (67%), NH black (89%), had MSM as the HIV transmission risk factor (44%), and had rental housing (58%). Overall, 477/621 (77%) had VS at intake. A lower proportion of individuals with VS were homeless with intake from the street (4.8% among VS vs. 11. 1% among not VS, p<0.0001). Out of the 734 HCS participants matched to surveillance data, 634/734 (86%) were retained in HIV care at the time of their HCS intake. A higher proportion of individuals retained in care were NH Black (89.3% NH Black among RIC vs 84.0 NH Black among not RIC). A higher proportion of those retained in care had Housing Voucher program support (29.5% with Housing Voucher program support among RIC vs 15.0% with Housing Voucher program support among not RIC, p=0.0024). In unadjusted analysis, among clients presenting to HCS for intake, being homeless (intake from the street rather than a shelter) was associated with not being virally suppressed. However, this association was not observed for retention in care. Although this analysis was not able to directly evaluate the receipt of housing services on VS and RIC, this will certainly be important for future study. Our results may imply that people who access HCS may need additional wraparound support for maintaining RIC and VS.

Open Access

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Comments

Presented at Research Days 2019.

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Examining how Housing Counseling Interventions Impact the Health Outcomes in Individuals with HIV in the DC area

People living with HIV/AIDS have at least three times the rate of homelessness as the general population. In Washington, DC, 2% of residents are living with HIV, with 15.3% of them experiencing homelessness. The primary objective of this study is to provide a descriptive comparison of health markers for individuals who have a diagnosis of HIV and received a housing intervention from Housing Counseling Services (HCS). This is a retrospective study examining data from HCS databases and the HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA) surveillance databases.The health outcomes evaluated include viral suppression (VS) and retention in care (RIC). Proportions of individuals with VS and/or RIC were compared across client subgroups (sex, race/ethnicity, age, housing situation at time of intake, type of support received from HCS, e.g.) using chi-square or rank sum tests. Of 734 HCS participants matched to HAHSTA surveillance data, 621 (85%) had data available at intake to evaluate the VS outcome. The sample was predominately male (67%), NH black (89%), had MSM as the HIV transmission risk factor (44%), and had rental housing (58%). Overall, 477/621 (77%) had VS at intake. A lower proportion of individuals with VS were homeless with intake from the street (4.8% among VS vs. 11. 1% among not VS, p<0.0001). Out of the 734 HCS participants matched to surveillance data, 634/734 (86%) were retained in HIV care at the time of their HCS intake. A higher proportion of individuals retained in care were NH Black (89.3% NH Black among RIC vs 84.0 NH Black among not RIC). A higher proportion of those retained in care had Housing Voucher program support (29.5% with Housing Voucher program support among RIC vs 15.0% with Housing Voucher program support among not RIC, p=0.0024). In unadjusted analysis, among clients presenting to HCS for intake, being homeless (intake from the street rather than a shelter) was associated with not being virally suppressed. However, this association was not observed for retention in care. Although this analysis was not able to directly evaluate the receipt of housing services on VS and RIC, this will certainly be important for future study. Our results may imply that people who access HCS may need additional wraparound support for maintaining RIC and VS.