Access to housing as a structural intervention for homeless and unstably housed people living with HIV: Rationale, methods, and implementation of the housing and health study
Access to housing as a structural intervention for homeless and unstably housed people living with HIV: Rationale, methods, and implementation of the housing and health study
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DOI：
10.1007/s10461-007-9249-0
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发表时间：
2007-11-01
影响因子：
4.4
通讯作者：
Stall, Ron
中科院分区：
文献类型：
--
作者：
Kidder, Daniel P.;Wolitski, Richard J.;Stall, Ron
无家可归和住房不稳定与HLV/ALDS(PLWHA)患者的艾滋病毒危险行为和较差的健康有关，但先前的研究尚未检验因果关系。本文描述了住房与健康研究的挑战、方法和基线样本，这是一项纵向、多地点、随机对照试验，旨在调查向无家可归或具有严重无家可归风险的PLWHA提供即时租赁住房援助的效果。主要结果包括艾滋病毒疾病进展、医疗服务的获得和利用、治疗依从性、心理和身体健康以及传播艾滋病毒的风险。在三个研究地点，630名参与者完成了基线会话，并被随机分为两组，一组接受立即租赁住房援助(治疗组)，另一组接受根据当地标准做法寻找住房的援助(对照组)。基线会议包括一份问卷，两次HIV风险降低咨询干预，以及采集血液样本以测量CD4计数和病毒载量水平。在基线后6个月、12个月和18个月进行三次随访。参与者大多是男性，黑人，未婚，低收入，近一半的人年龄在40岁到49岁之间。在18个月时，基线样本的84%被保留。保留率证明了进行科学严谨的住房研究的可行性，基线结果提供了关于这一研究不足的人口特征的重要信息，可以为未来的艾滋病毒预防和治疗工作提供参考。
Homelessness and unstable housing have been associated with HIV risk behavior and poorer health among persons living with HlV/AlDS (PLWHA), yet prior research has not tested causal associations. This paper describes the challenges, methods, and baseline sample of the Housing and Health Study, a longitudinal, multi-site, randomized controlled trial investigating the effects of providing immediate rental housing assistance to PLWHA who were homeless or at severe risk of homelessness. Primary outcomes included HIV disease progression, medical care access and utilization, treatment adherence, mental and physical health, and risks of transmitting HIV. Across three study sites, 630 participants completed baseline sessions and were randomized to receive either immediate rental housing assistance (treatment group) or assistance finding housing according to local standard practice (comparison group). Baseline sessions included a questionnaire, a two-session HIV risk-reduction counseling intervention, and blood sample collection to measure CD4 counts and viral load levels. Three follow-up visits occurred at 6, 12, and 18 months after baseline. Participants were mostly male, Black, unmarried, low-income, and nearly half were between 40 and 49 years old. At 18 months, 84% of the baseline sample was retained. The retention rates demonstrate the feasibility of conducting scientifically rigorous housing research, and the baseline results provide important information regarding characteristics of this understudied population that can inform future HIV prevention and treatment efforts.