Housing First: Unsuppressed Viral Load Among Women Living with HIV in San Francisco

被引:33
作者
Riley, Elise D. [1 ]
Vittinghoff, Eric [2 ]
Koss, Catherine A. [1 ]
Christopoulos, Katerina A. [1 ]
Clemenzi-Allen, Angelo [1 ]
Dilworth, Samantha E. [3 ]
Carrico, Adam W. [4 ]
机构
[1] Univ Calif San Francisco, Dept Med, Div HIV Infect Dis & Global Med, 1001 Potrero Ave,UCSF Mailbox 0874, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
[3] Univ Calif San Francisco, Dept Med, Div Prevent Sci, San Francisco, CA 94143 USA
[4] Univ Miami, Dept Publ Hlth Sci, Miami, FL USA
基金
美国国家卫生研究院;
关键词
HIV; Viral suppression; Women; Homeless; Incarceration; UNSTABLY HOUSED WOMEN; INTIMATE PARTNER VIOLENCE; SUBSTANCE USE DISORDERS; SOCIAL SUPPORT; MENTAL-HEALTH; MEDICAL-CARE; SEX WORKERS; ANTIRETROVIRAL TREATMENT; ANCILLARY SERVICES; FOOD INSECURITY;
D O I
10.1007/s10461-019-02601-w
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
While poverty is an established barrier to achieving success at each step of the HIV care continuum, less is known about specific aspects of poverty and how they overlap with behavior in exceptionally low-income individuals who live in well-resourced areas. We considered unsuppressed viral load over 3 years among women living with HIV in San Francisco who used homeless shelters, low-income hotels and free meal programs. One-hundred twenty study participants were followed; 60% had > 1 unsuppressed viral load and 19% were unsuppressed at every visit. Across six-month intervals, the odds of unsuppressed viral load were 11% higher for every 10 nights spent sleeping on the street [Adjusted Odds Ratio (AOR) 1.11, 95% CI 1.02-1.20]; 16% higher for every 10 nights spent sleeping in a shelter (AOR/10 nights 1.16, 95% CI 1.06-1.27); 4% higher for every 10 nights spent sleeping in a single-room occupancy hotel (AOR/10 nights 1.04, 95% CI 1.02-1.07); and over threefold higher among women who experienced any recent incarceration (AOR 3.56, 95% CI 1.84-6.86). Violence and recent use of outpatient health care did not significantly predict viral suppression in adjusted analysis. While strategies to promote retention in care are important for vulnerable persons living with HIV, they are insufficient to ensure sustained viral suppression in low-income women experiencing homelessness and incarceration. Results presented here in combination with prior research linking incarceration to homelessness among women indicate that tailored interventions, which not only consider but prioritize affordable housing, are critical to achieving sustained viral suppression in low-income women living with HIV.
引用
收藏
页码:2326 / 2336
页数:11
相关论文
共 50 条
[41]   Viral load non-suppression among adolescents and youth living with HIV in South Africa [J].
Molopa, Lesiba O. ;
Ginyana, Thembelihle P. ;
Vondo, Noloyiso ;
Magobo, Rindidzani ;
Maseko, Goitseone ;
Zungu, Nompumelelo ;
Zuma, Khangelani ;
Simbayi, Leickness ;
Mabaso, Musawenkosi ;
Moyo, Sizulu .
SOUTHERN AFRICAN JOURNAL OF INFECTIOUS DISEASES, 2024, 39 (01)
[42]   Determinants of viral load suppression among orphaned and vulnerable children living with HIV on ART in Tanzania [J].
Ally, Amal ;
Exavery, Amon ;
Charles, John ;
Kikoyo, Levina ;
Mseya, Remmy ;
Barankena, Asheri ;
Fovo, Rose ;
Temu, Akwila .
FRONTIERS IN PUBLIC HEALTH, 2023, 11
[43]   Impact of antiretroviral regimen on viral suppression among pregnant women living with HIV in Brazil [J].
Pascom, Ana R. Pati ;
Fonseca, Fernanda F. ;
Pinho, Rosana Goncalves Goncalves ;
Perini, Filipe Barros ;
Pereira, Gerson ;
Avelino-Silva, Vivian, I .
INTERNATIONAL JOURNAL OF STD & AIDS, 2020, 31 (09) :903-910
[44]   Examining age as a moderating effect on the relationship between alcohol use and viral suppression among women living with HIV [J].
Crawford, Timothy N. ;
Harris, Lesley M. ;
Peyrani, Paula .
WOMEN & HEALTH, 2019, 59 (07) :789-800
[45]   Injection risk behavior among women syringe exchangers in San Francisco [J].
Lum, PJ ;
Sears, C ;
Guydish, J .
SUBSTANCE USE & MISUSE, 2005, 40 (11) :1681-1696
[46]   Housing Patterns and Correlates of Homelessness Differ by Gender among Individuals Using San Francisco Free Food Programs [J].
Elise D. Riley ;
Sheri D. Weiser ;
James L. Sorensen ;
Samantha Dilworth ;
Jennifer Cohen ;
Torsten B. Neilands .
Journal of Urban Health, 2007, 84 :415-422
[47]   Housing patterns and correlates of homelessness differ by gender among individuals using San Francisco free food programs [J].
Riley, Elise D. ;
Weiser, Sheri D. ;
Sorensen, James L. ;
Dilworth, Samantha ;
Cohen, Jennifer ;
Neilands, Torsten B. .
JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE, 2007, 84 (03) :415-422
[48]   Social Determinants of Health and Retention in HIV Care Among Recently Incarcerated Women Living with HIV in Canada [J].
Gormley, Rebecca ;
Lin, Sally Y. ;
Carter, Allison ;
Nicholson, Valerie ;
Webster, Kath ;
Martin, Ruth Elwood ;
Milloy, M-J ;
Pick, Neora ;
Howard, Terry ;
Wang, Lu ;
de Pokomandy, Alexandra ;
Loutfy, Mona ;
Kaida, Angela .
AIDS AND BEHAVIOR, 2020, 24 (04) :1212-1225
[49]   The Effect of Various Supportive Housing Models on ART Adherence Among Persons Living With HIV in Supportive Housing [J].
Quinn, Katherine G. ;
DiFranceisco, Wayne ;
Spector, Antoinette ;
Bendixen, Art ;
Peters, Amanda ;
Dickson-Gomez, Julia .
MEDICAL CARE, 2021, 59 (04) :S124-S131
[50]   HCV screening in a cohort of HIV infected and uninfected homeless and marginally housed women in San Francisco, California [J].
Kimberly Page ;
Michelle Yu ;
Jennifer Cohen ;
Jennifer Evans ;
Martha Shumway ;
Elise D. Riley .
BMC Public Health, 17