Randomized trial of the effects of housing assistance on the health and risk behaviors of homeless and unstably housed people living with HIV.
Homelessness affects HIV risk and health, but little is known about the longitudinal effects of rental assistance on the housing status and health of homeless and unstably housed people living with HIV/AIDS. Homeless/unstably housed people living with HIV/AIDS (N = 630) were randomly assigned to immediate Housing Opportunities for People with AIDS (HOPWA) rental assistance or customary care. Self-reported data, CD4, and HIV viral load were collected at baseline, 6, 12, and 18 months. Results showed that housing status improved in both groups, with greater improvement occurring in the treatment group. At 18 months, 51% of the comparison group had their own housing, limiting statistical power. Intent-to-treat analyses demonstrated significant reductions in medical care utilization and improvements in self-reported physical and mental health; significant differential change benefiting the treatment group was observed for depression and perceived stress. Significant differences between homeless and stably housed participants were found in as-treated analyses for health care utilization, mental health, and physical health. HOPWA rental assistance improves housing status and, in some cases, health outcomes of homeless and unstably housed people living with HIV/AIDS.
Wolitski
Richard J
RJ
Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton RD NE (E-35), Atlanta, GA, USA. RWolitski@cdc.gov
Kidder
Daniel P
DP
Pals
Sherri L
SL
Royal
Scott
S
Aidala
Angela
A
Stall
Ron
R
Holtgrave
David R
DR
Harre
David
D
Courtenay-Quirk
Cari
C
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006304:Health Status; D006703:Ill-Housed Persons; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011632:Public Assistance / Q000706:statistics & numerical data; D012309:Risk-Taking; D012725:Sexual Behavior; D016896:Treatment Outcome; D055815:Young Adult