Do HIV risk and prevention behaviors change over time among adults in permanent supportive housing?
Open accessAbstract
Persons experiencing homelessness have a disproportionate burden of HIV infection and high rates of HIV risk behavior. Permanent supportive housing (PSH) has been identified as a primary solution to homelessness, but little is known about HIV sexual risk behavior among persons in PSH, nor about how HIV risk and prevention behavior may change as persons move from homelessness into PSH. Utilizing longitudinal data from 421 persons prior to moving in and over their first year living in PSH, this study assesses change over time in HIV risk and prevention behavior utilizing generalized linear mixed models. Results reveal changes in sexual risk behavior over time, including an overall increase in the rate of sexual activity, but a decrease in rates of some sexual risk behaviors, including condomless sex and multiple partners. While decreasing overall, the prevalence of condomless sex remains high (63%) at 12-months. Combined with a precipitous drop in HIV prevention programming exposure (from 56% at baseline to 23% at 12-months), only two-thirds of those sexually active reporting a past year HIV test at 12-months post-housing, and rare use of PrEP, these findings suggest a need for additional attention to promotion of sexual health behaviors and HIV prevention within PSH.
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The generally positive effects of Housing First on viral health outcomes from five studies in this review are consistent with findings from broader research on permanent supportive housing.
“Caution is warranted in drawing inferences from these studies, though the generally positive effects of Housing First on viral health outcomes from five studies in this review are consistent with findings from broader research on permanent supportive housing (e.g., Buchanan et al., 2009; Hall et al., 2019; Wenzel et al., 2019), providing a degree of assurance.”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Wenzel et al., 2019
The Introduction reports a prior study linking long-term supportive housing to fewer new HIV infections, and the Discussion reports declines in some HIV risk behaviors among this study’s PSH residents (pages not provided). But Wenzel et al. did not measure viral health outcomes or establish a generally positive effect on them; its findings concern risk and prevention behaviors, with substantial risk remaining. (LLM, conf=0.82)
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Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review
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Examining HIV Risk and Exchange Sex Among Current and Formerly Homeless Young Adults
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Changes in Physical Assault Among Adults Moving Into Permanent Supportive Housing
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Life meaning in a social context among formerly homeless residents of permanent supportive housing
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- Authors
- Wenzel, S. L., Rhoades, H., La Motte-Kerr, W., Duan, L., Harris, T., Rice, E., & Henwood, B. F.
- Affiliations
- University of Southern California (US)
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, US
- Corresponding author
- Wenzel, Suzanne L.
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2019-02-06
- Volume
- 31
- Issue
- 9
- Pages
- 1172-1177
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- PMC
- PMC6625922
- OpenAlex
- W2912999343
- Cited by
- 11
- References
- 20
- Citations by year
- 2022: 1 · 2021: 5 · 2020: 1 · 2019: 4
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA036345)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV risk behavior, HIV prevention, permanent supportive housing, homelessness, unprotected sex, multiple sexual partners, HIV testing, HIV pre-exposure prophylaxis, sexual health, housing transitions, HIV prevention programs
- MeSH terms
- Adult, Female, Ill-Housed Persons, Housing, Humans, Longitudinal Studies, Male, Middle Aged, Risk-Taking, Los Angeles, Health Behavior, HIV Infections, Unsafe Sex
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