Housing Subsidies and Housing Stability are Associated with Better HIV Medical Outcomes Among Persons Who Experienced Ho
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ORIGINAL PAPER
Housing Subsidies and Housing Stability are Associated with Better HIV Medical Outcomes Among Persons Who Experienced Homelessness and Live with HIV and Mental Illness or Substance Use Disorder Ellen W. Wiewel1 · Tejinder P. Singh2 · Yaoyu Zhong1 · Christopher M. Beattie1 · Sungwoo Lim2 · Sarah Walters2 · Sarah L. Braunstein1 · John Rojas1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Among 958 applicants to a supportive housing program for low-income persons living with HIV (PLWH) and mental illness or a substance use disorder, we assessed impacts of housing placement on housing stability, HIV care engagement, and viral suppression. Surveillance and administrative datasets provided medical and residence information, including stable (e.g., rental assistance, supportive housing) and unstable (e.g., emergency shelter) government-subsidized housing. Sequence analysis identified a “quick stable housing” pattern for 67% of persons placed by this program within 2 years, vs. 28% of unplaced. Compared with unplaced persons not achieving stable housing quickly, persons quickly achieving stable housing were more likely to engage in care, whether placed (per Poisson regression, ARR: 1.14;95% CI 1.09–1.20) or unplaced (1.19;1.13–1.25) by this program, and to be virally suppressed, whether placed (1.22;1.03–1.44) or unplaced (1.26, 1.03–1.56) by this program. Housing programs can help homeless PLWH secure stable housing quickly, manage their infection, and prevent transmission. Keywords Housing · HIV/AIDS · Medical care · Evaluation · Mental health Resumen Unas 958 personas de bajos recursos y quienes viven con VIH y enfermedades mentales o bien presentan problemas de abuso de sustancias solicitaron a un programa de vivienda complementada con servicios de apoyo. Entre ellas, se evaluó los impactos de la colocación en viviendas sobre la estabilidad en la misma, así como la participación en los cuidados médicos para el VIH, y la supresión de la carga viral. Las bases de datos administrativas y del registro de vigilancia brindaron información médica y domiciliar, incluyendo información sobre vivienda estable (por ejemplo, asistencia de pago de renta a largo plazo, o vivienda complementada con servicios de apoyo) y vivienda inestable (por ejemplo, alojamiento de emergencia temporal) subsidiada por el gobierno. El método “análisis de secuencia” permitió identificar una pauta caracterizada por estabilidad domiciliar conseguida de modo ligero (es decir, de forma oportuna) en el 67% de las personas quienes fueron colocadas por Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10461-020-02810-8) contains supplementary material, which is available to authorized users. * Ellen W. Wiewel [email protected] 1
Division of Disease Control, New York City Department of Health and Mental Hygiene, 42‑09 28 th Street, CN‑44, Long Island City, NY 11101, USA
Division of Epidemiology, New York City Department of Health and Mental Hygiene
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