Nurses in supportive housing are associated with decreased health care utilization and improved HIV biomarkers in formerly homeless adults
Abstract
A San Francisco study conducted in 2008 showed that the permanent supportive housing program, Direct Access to Housing, dramatically decreased the risk of death in people living with HIV. In our study, we compared the health care utilization patterns and HIV-related biological markers of formerly homeless adults with HIV before and during two types of permanent supportive housing: (a) housing with on-site nursing care for residents, and (b) housing without on-site nursing care. Using nearest-neighbor matching with propensity scoring, the difference in outcomes was calculated. In the matched analysis, adjusted for adherence to combination antiretroviral therapy, people housed at sites with nurses had 4.8 fewer emergency department visits per person (SE: 1.53, p < .01), and they had an increased mean CD4+ T cell count (101.14 cells per person [SE: 55.10, p < .05]) compared to those who lived at sites without nurses.
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In homeless adults with medical problems, mental health disabilities, and/or substance dependence, onsite nursing care at supportive housing sites was non-significantly associated with mean CD4+ T cell counts, suppressed viral load ≤40 copies/mL, and viral load ≥400 copies/mL.
“but non-significantly to mean CD4 + T cell counts, suppressed viral load ≤40 copies/mL, and viral load ≥400 copies/mL”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Dobbins et al. (2016)
Cites
Beijer, U., Wolf, A., & Fazel, S. (2012) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70177-9 · Cited by 357 · see citing works
Mortality among homeless shelter residents in New York City.
Barrow, S. M., Herman, D. B., Córdova, P., & Struening, E. L. (1999) · American Journal of Public Health · doi:10.2105/ajph.89.4.529 · Cited by 322 · see citing works
for the Housing and Health Study Team, Wolitski, R. J., Kidder, D. P., Pals, S. L., Royal, S., Aidala, A., Stall, R., Holtgrave, D. R., Harre, D., & Courtenay-Quirk, C. (2010) · AIDS and Behavior · doi:10.1007/s10461-009-9643-x · Cited by 218 · cited 2× · see citing works
“Supportive housing for those who are homeless and living with HIV has been established as a successful intervention that can improve HIV treatment adherence, extend years of life lived, and improve the quality of life lived (Arno et al., 1996; Schwarcz et al., 2009; Wolitski et al., 2010).”
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Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review
Kerman, N., Polillo, A., Bardwell, G., Gran-Ruaz, S., Savage, C., Felteau, C., & Tsemberis, S. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.109052 · Cited by 42 · see citing works
Bowen, E. A., Canfield, J., Moore, S., Hines, M., Hartke, B., & Rademacher, C. (2017) · AIDS Care · doi:10.1080/09540121.2017.1307920 · Cited by 28 · see citing works
- Authors
- Dobbins, S. K., Cruz, M., Shah, S., Abt, L., Moore, J., & Bamberger, J.
- Affiliations
- University of San Francisco (US)
- San Francisco Department of Public Health (US)
- Corresponding author
- Dobbins, Sarah K.
- ORCID
- Dobbins, Sarah K.
- Venue
- Journal of the Association of Nurses in AIDS Care
- Published
- 2016-07
- Volume
- 27
- Issue
- 4
- Pages
- 444-454
- ISSN
- 1055-3290 (ISSN-L)
- OpenAlex
- W2226458504
- Cited by
- 9
- References
- 3
- Citations by year
- 2026: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2018: 1 · 2017: 3
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the Association of Nurses in AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- permanent supportive housing, HIV, health care utilization, emergency department visits, CD4 count, antiretroviral therapy adherence, homelessness
- MeSH terms
- Assessment of Medication Adherence, Adult, Emergency Service, Hospital, Female, Health Services, Health Services Accessibility, Ill-Housed Persons, Humans, Nurses, Patient Acceptance of Health Care, Public Housing, San Francisco, Biomarkers, CD4-Positive T-Lymphocytes, HIV Infections, Multivariate Analysis, Logistic Models, Drug Monitoring, Nurse's Role, Anti-Retroviral Agents, Medication Adherence
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