David Buchanan1, Romina Kee, Laura S Sadowski, Diana Garcia. 1. John Stroger Hospital of Cook County (formerly Cook County Hospital), Chicago, IL, and Rush University, Chicago, USA. dbuchanan@eriefamilyhealth.org
Abstract
OBJECTIVES: We assessed the health impact of a housing and case management program, the Chicago Housing for Health Partnership, for homeless people with HIV. METHODS:HIV-positive homeless inpatients at a public hospital (n = 105) were randomized to usual care or permanent housing with intensive case management. The primary outcome was survival with intact immunity, defined as CD4 count > or = 200 and viral load < 100,000. Secondary outcomes were viral loads, undetectable viral loads, and CD4 counts. RESULTS: Outcomes were available for 94 of 105 enrollees (90%). Of 54 intervention participants, 35 (65%) reached permanent housing in program housing agencies. After 1 year, 55% of the intervention and 34% of the usual care groups were alive and had intact immunity (P = .04). Seventeen intervention (36%) and 9 usual care (19%) participants had undetectable viral loads (P = .051). Median viral loads were 0.89 log lower in the intervention group (P = .03). There were no statistical differences in CD4 counts. CONCLUSIONS: Homelessness is a strong predictor of poor health outcomes and complicates the medical management of HIV. This housing intervention improved the health of HIV-positive homeless people.
RCT Entities:
OBJECTIVES: We assessed the health impact of a housing and case management program, the Chicago Housing for Health Partnership, for homeless people with HIV. METHODS: HIV-positive homeless inpatients at a public hospital (n = 105) were randomized to usual care or permanent housing with intensive case management. The primary outcome was survival with intact immunity, defined as CD4 count > or = 200 and viral load < 100,000. Secondary outcomes were viral loads, undetectable viral loads, and CD4 counts. RESULTS: Outcomes were available for 94 of 105 enrollees (90%). Of 54 intervention participants, 35 (65%) reached permanent housing in program housing agencies. After 1 year, 55% of the intervention and 34% of the usual care groups were alive and had intact immunity (P = .04). Seventeen intervention (36%) and 9 usual care (19%) participants had undetectable viral loads (P = .051). Median viral loads were 0.89 log lower in the intervention group (P = .03). There were no statistical differences in CD4 counts. CONCLUSIONS: Homelessness is a strong predictor of poor health outcomes and complicates the medical management of HIV. This housing intervention improved the health of HIV-positive homeless people.
Authors: Marjorie J Robertson; Richard A Clark; Edwin D Charlebois; Jacqueline Tulsky; Heather L Long; David R Bangsberg; Andrew R Moss Journal: Am J Public Health Date: 2004-07 Impact factor: 9.308
Authors: Jesse B Milby; Joseph E Schumacher; Rudy E Vuchinich; Dennis Wallace; Mary Ann Plant; Michelle J Freedman; Cecelia McNamara; Catherine L Ward Journal: Psychol Addict Behav Date: 2004-09
Authors: Andrew R Moss; Judith A Hahn; Sharon Perry; Edwin D Charlebois; David Guzman; Richard A Clark; David R Bangsberg Journal: Clin Infect Dis Date: 2004-09-27 Impact factor: 9.079
Authors: Brooke Herndon; Steven M Asch; Amy M Kilbourne; MingMing Wang; Martin Lee; Suzanne L Wenzel; Ronald Andersen; Lillian Gelberg Journal: Public Health Rep Date: 2003 May-Jun Impact factor: 2.792
Authors: Sameed Ahmed M Khatana; Rishi K Wadhera; Eunhee Choi; Peter W Groeneveld; Dennis P Culhane; Margot Kushel; Dhruv S Kazi; Robert W Yeh; Changyu Shen Journal: J Gen Intern Med Date: 2020-06-17 Impact factor: 5.128