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The Health Impact of Supportive Housing for HIV-Positive Homeless Patients: A Randomized Controlled Trial
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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.
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“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 Buchanan et al., 2009
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Metadata
- Authors
- Buchanan, D., Kee, R., Sadowski, L. S., & Garcia, D.
- Affiliations
- John H. Stroger, Jr. Hospital of Cook County (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2009-11
- Volume
- 99
- Issue
- S3
- Pages
- S675-S680
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC2774195
- OpenAlex
- W1976900967
- Cited by
- 190
- References
- 28
- Citations by year
- 2026: 8 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 13 · 2021: 24 · 2020: 19 · 2019: 24 · 2018: 9 · 2017: 15 · 2016: 12 · 2015: 14 · 2014: 7 · 2013: 6 · 2012: 12
- FWCI
- 16.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Michael Reese Health Trust
- Topics
- Social Sciences › Sociology and Political Science › Homelessness and Social Issues
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV, homelessness, supported housing, case management, viral load, CD4 count, HIV survival
- MeSH terms
- Adult, Chicago, Female, Health Status, HIV Seropositivity, Ill-Housed Persons, Humans, Male, Middle Aged, Public Housing, Residential Facilities, Social Support
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