title: Drug use and emotional distress differentiate unstably- versus stably-housed adults living with HIV who engage in unprotected sex.
abstract: Among adults living with HIV, unstable housing is a barrier to health. Stably- and unstably-housed adults living with HIV were assessed for over 25 months. At baseline, unstably-housed adults living with HIV had a more recent HIV diagnosis, higher viral loads, worse physical and mental health, lower rates of antiretroviral therapy use and insurance coverage, and higher rates of hard drug use than stably-housed adults living with HIV. At follow-up, the health of both groups was similar, but unstably-housed adults living with HIV reported significantly more hard drug use and mental health symptoms when compared to the stably-housed adults living with HIV. Drug and mental health risks decreased for both groups, but decreases in unprotected sex were greater among unstably-housed adults living with HIV.
authors.affiliation: 1 Wake Forest University Baptist Medical Center, USA.
authors.forename: Elizabeth Mayfield
authors.initials: EM
authors.lastname: Arnold
authors.affiliation: 2 University of California, Los Angeles, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Desmond
authors.affiliation: 2 University of California, Los Angeles, USA.
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Rotheram-Borus
authors.affiliation: 2 University of California, Los Angeles, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Scheffler
authors.affiliation: 2 University of California, Los Angeles, USA.
authors.forename: W Scott
authors.initials: WS
authors.lastname: Comulada
authors.affiliation: 3 University of California, San Francisco, USA.
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.affiliation: 4 Medical College of Wisconsin, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kelly
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D013315:Stress, Psychological / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D047568:Unsafe Sex / Q000706:statistics & numerical data*
keywords: HIV; high-risk sex; mental health; physical health; substance use; unstably-housed adults living with HIV