The health impact of supportive housing for HIV-positive homeless patients: a randomized controlled trial

Am J Public Health. 2009 Nov;99 Suppl 3(Suppl 3):S675-80. doi: 10.2105/AJPH.2008.137810. Epub 2009 Apr 16.

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chicago
  • Female
  • HIV Seropositivity*
  • Health Status*
  • Homeless Persons*
  • Humans
  • Male
  • Middle Aged
  • Public Housing*
  • Residential Facilities*
  • Social Support