title: Health status, health care use, medication use, and medication adherence among homeless and housed people living with HIV/AIDS.
abstract: OBJECTIVE
  We sought to compare health status, health care use, HIV anti-retroviral medication use, and HIV medication adherence among homeless and housed people with HIV/AIDS.
  
  
  METHODS
  Data were obtained from a cross-sectional, multisite behavioral survey of adults (N=7925) recently reported to be HIV positive.
  
  
  RESULTS
  At the time interviews were conducted, 304 respondents (4%) were homeless. Self-ratings of mental, physical, and overall health revealed that the health status of homeless respondents was poorer than that of housed respondents. Also, homeless respondents were more likely to be uninsured, to have visited an emergency department, and to have been admitted to a hospital. Homeless respondents had lower CD4 counts, were less likely to have taken HIV anti-retroviral medications, and were less adherent to their medication regimen. Homeless respondents needed more HIV social and medical services, but nearly all respondents in both groups had received needed services. Housing status remained a significant predictor of health and medication outcomes after we controlled for potential confounding variables.
  
  
  CONCLUSIONS
  Homeless people with HIV/AIDS are at increased risk of negative health outcomes, and housing is a potentially important mechanism for improving the health of this vulnerable group.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA. dkidder@cdc.gov
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Kidder
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wolitski
authors.forename: Michael L
authors.initials: ML
authors.lastname: Campsmith
authors.forename: Glenn V
authors.initials: GV
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D012111:Residence Characteristics; D019966:Substance-Related Disorders / Q000821:virology; D014481:United States
chemical_list: D019380:Anti-HIV Agents