The health impact of supportive housing for HIV-positive homeless patients: a randomized controlled trial.
OBJECTIVE
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.
John Stroger Hospital of Cook County (formerly Cook County Hospital), Chicago, IL, and Rush University, Chicago, USA. dbuchanan@eriefamilyhealth.org
David
D
Buchanan
Romina
R
Kee
Laura S
LS
Sadowski
Diana
D
Garcia
D000328:Adult; D002641:Chicago; D005260:Female; D006679:HIV Seropositivity; D006304:Health Status; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D011638:Public Housing; D012112:Residential Facilities; D012944:Social Support