title: Relationship between Housing Status and Retention Rates among HIV-Positive African Americans Enrolled in a Comprehensive Care Program.
abstract: Service provision using "one-stop shopping" of medical, psychiatric, and case management services at the same location has been associated with superior client retention. The Yadumu project tested this premise, with attention to HIV-infected African Americans. Each client was assigned a case manager, who arranged meetings with mental health, substance abuse, and medical care professionals. The Center for Mental Health Services, National Outcome Measures (CMHS NOMs) questionnaire was used to evaluate client progress. Data were collected longitudinally and the program evaluation was performed by an outside center. Among 129 clients, 47% were male, 30% were female, and 22% were transgender. The majority (72%) were African American. Clients who lived in detox/drug treatment programs had higher completion rates (48%) than those who were homeless or otherwise housed (28%) (p = 0.04). Logistic regression was used to assess associations between independent factors and retention. Clients satisfied with their housing situation were less likely to retain in the program than those who were not satisfied with their housing situation (OR = 0.15, 95% CI: 0.03-0.78). High discharge rates among HIV-infected people were observed and may reflect the unstable circumstances of the population studied, but structured residential programs could be advantageous for improving retention.
authors.affiliation: a Physician, Department of Internal Medicine , Whan Donghu Hospital , Wuhan , China.|b Outpatient Volunteer Physician , Haight Ashbury Free Clinic , San Francisco , CA , USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Xiao
authors.affiliation: c Psychiatrist, Telecare Corporation , Oakland , CA , USA.|d Outpatient Staff Psychiatrist , Haight Ashbury Free Clinic , San Francisco , CA , USA.
authors.forename: William
authors.initials: W
authors.lastname: Mains
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D019090:Case Management; D003191:Comprehensive Health Care / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000628:therapy; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D015397:Program Evaluation; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: HIV; housing; integrated service; mental health; substance abuse