The Influence of Housing Status on the HIV Continuum of Care: Results From a Multisite Study of Patient Navigation Models to Build a Medical Home for People Living With HIV Experiencing Homelessness

• Published in: American journal of public health (1971) Vol. 108; no. S7; pp. S539 - S545
• Main Authors: Rajabiun, Serena, Tryon, Janell, Feaster, Matt, Pan, Amy, McKeithan, Lisa, Fortu, Karen, Cabral, Howard J., Borne, Deborah, Altice, Frederick L.
• Format: Journal Article
• Language: English
• Published: Washington American Public Health Association 01.12.2018
• Subjects: Acquired immune deficiency syndrome; AIDS; AJPH Open-Themed Research; Antiretroviral agents; Antiretroviral therapy; Behavior; Drug therapy; Drug use; Enrollments; Health facilities; Health Service Delivery; HIV; HIV/AIDS; Homeless people; Homelessness; Housing; Housing authorities; Human immunodeficiency virus; Intervention; Interviews; Medical treatment; Medicine; Mental disorders; Mental health care; Mental health services; Navigation; Navigators; Patients; Prescription drugs; Primary care; Public health; Retention; Stability; Substance abuse; Substance use; United States > US; San Francisco California
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2018.304736

Objectives. To examine the effect of patient navigation models on changes in housing status and its subsequent effects on HIV outcomes for 700 people living with HIV (PLWH) who were unstably housed with co-occurring substance use and psychiatric disorders across 9 demonstration sites in the United States between the years of 2013 and 2017. Methods. Self-reported housing status was collected at baseline, and at 6 and 12 months during the intervention. HIV outcomes included linkage and retention in care, antiretroviral therapy prescription, and viral suppression collected via chart review. Results. In the 12 months after the intervention, 59.6% transitioned to more stable housing. Compared with those who became or remained unstably housed, participants with greater stability achieved significantly higher rates of retention (adjusted odds ratio [AOR] = 2.12; 95% confidence interval [CI] = 1.11, 4.05), were more likely to be prescribed antiretroviral therapy (AOR = 2.06; 95% CI = 1.62, 2.63), and had higher rates of viral suppression (AOR = 1.62; 95% CI = 1.03, 2.55). Conclusions. The use of patient navigators to create a network of services for PLWH who are unstably housed can improve housing stability and lead to improvements in HIV-related outcomes.