The impact of the housing status on clinical outcomes and health care utilization among individuals living with HIV
The impact of the housing status on clinical outcomes and health care utilization among individuals living with HIV
复制标题
住房状况对艾滋病毒感染者临床结果和医疗保健利用的影响
作者：
Anela Stanic;Denis Rybin;Francis Cannata;Carole A. Hohl;J. Brody;Jessie M. Gaeta;M. Bharel
摘要缺乏稳定的住房会影响人类免疫缺陷病毒（HIV）感染者获得护理的机会和连续性。本研究调查了在多个时间点评估的住房状况与同一组经历无家可归的艾滋病毒感染者的几个核心艾滋病毒相关结果之间的关系。在这一年中，将持续稳定住房（CSH）的患者与缺乏CSH的患者（非CSH组）进行比较。研究结果包括HIV病毒载量（VL）、CD4计数和卫生保健利用。多变量和倾向加权分析用于评估调整潜在组差异的结局。在208例患者中，88例（42%）患有CSH，120例（58%）为非CSH。CSH患者的VL抑制比例显着较高，平均CD 4计数也较高。CSH组的护士访视频率不到非CSH组的一半。CSH患者不太可能被允许进入医疗暂托设施，如果被允许，他们的住院时间约为非CSH组的一半。我们的研究结果表明，CSH患者有显着更好的艾滋病毒控制和免疫状态，以及改善卫生保健利用。
ABSTRACT The lack of stable housing can impair access and continuity of care for patients living with human immunodeficiency virus (HIV). This study investigated the relationship between housing status assessed at multiple time points and several core HIV-related outcomes within the same group of HIV patients experiencing homelessness. Patients with consistently stable housing (CSH) during the year were compared to patients who lacked CSH (non-CSH group). The study outcomes included HIV viral load (VL), CD4 counts, and health care utilization. Multivariable and propensity weighted analyses were used to assess outcomes adjusting for potential group differences. Of 208 patients, 88 (42%) had CSH and 120 (58%) were non-CSH. Patients with CSH had significantly higher proportion of VL suppression and higher mean CD4 counts. The frequency of nurse visits in the CSH group was less than a half of that in the non-CSH group. Patients with CSH were less likely to be admitted to the medical respite facility, and if admitted, their length of stay was about a half of that for the non-CSH group. Our study findings show that patients with CSH had significantly better HIV virologic control and immune status as well as improved health care utilization.