Effect of HIV Housing Services on Engagement in Care and Treatment, New York City, 2011

Terzian, Arpi; Irvine, Mary K.; Hollod, Laura; Lim, Sungwoo; Rojas, John; Shepard, Colin W.

doi:10.1007/s10461-015-1003-4

Cited by 28 publications

(13 citation statements)

References 25 publications

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“…A recent study tracked treatment outcomes for PLWH who received housing supports via the federal Housing Opportunities for People with AIDS (HOPWA) program, comparing participants to a random sample of PLWH who were not HOPWA recipients. While this study found significant increases in retention in care for the intervention group, no differences were found in rates of viral suppression (26). Nonetheless, a systematic review of 152 studies that examined associations between housing and clinical outcomes (including treatment adherence and viral suppression) found an independent effect of housing on HIV health outcomes for homeless or formerly homeless PLWH (29).…”

Section: Discussioncontrasting

confidence: 69%

“…A study recently examined treatment outcomes for PLWH who received housing supports via the federal Housing Opportunities for People with AIDS (HOPWA) program, comparing participants to a random sample of PLWH who were not HOPWA recipients. This study found significant increases in retention in care for the intervention group, however, no differences in rates of viral suppression were noted (26). In addition, the study was limited to a specific subset of PLWH, namely, those receiving HOPWA support.…”

Section: Introductionmentioning

confidence: 72%

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HIV Treatment Cascade by Housing Status at Enrollment: Results from a Retention in Care Cohort

et al. 2018

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Though housing instability is linked to poor HIV health outcomes, studies that assess the HIV treatment cascade by housing status are limited. Using data from a multi-site Retention in Care initiative we constructed HIV treatment cascades for participants (n=463) of five grantee sites. We found no significant differences in viral suppression at follow-up among participants who were unstably housed at enrollment (49%) as compared to those who were stably housed at enrollment Conflict of Interest: The authors declare that they have no conflicts of interest. Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent: All data collection activities by sites independently underwent IRB review prior to execution. Evaluation activities conducted by the institution overseeing evaluation activities were determined to be non-human subjects research.

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Section: Discussioncontrasting

confidence: 69%

Section: Introductionmentioning

confidence: 72%

HIV Treatment Cascade by Housing Status at Enrollment: Results from a Retention in Care Cohort

et al. 2018

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Section: Discussionmentioning

confidence: 94%

“…A strength of this analysis is that we used a novel strategy of combining HCV programme and surveillance data for evaluation purposes. Similar analyses have been conducted using HIV surveillance data to evaluate HIV programmes, but to our knowledge, this is the first evaluation to examine the impact of HCV care coordination using a demographically similar comparison group reported to a city‐wide surveillance registry. This novel method offers a relatively inexpensive approach for local health departments to support HCV programme evaluation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a hepatitis C clinical care coordination programme’s effect on treatment initiation and cure: A surveillance‐based propensity score matching approach

Deming

Ford

Moore

et al. 2018

Journal of Viral Hepatitis

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Hepatitis C (HCV) is a viral infection that if left untreated can severely damage the liver. Project INSPIRE was a 3 year HCV care coordination programme in New York City (NYC) that aimed to address barriers to treatment initiation and cure by providing patients with supportive services and health promotion. We examined whether enrolment in Project INSPIRE was associated with differences in HCV treatment and cure compared with a demographically similar group not enrolled in the programme. INSPIRE participants in 2015 were matched with a cohort of HCV-infected persons identified in the NYC surveillance registry, using full optimal matching on propensity scores and stratified by INSPIRE enrolment status. Conditional logistic regression was used to assess group differences in the two treatment outcomes. Two follow-up sensitivity analyses using individual pair-matched sets and the full unadjusted cohort were also conducted. Treatment was initiated by 72% (790/1130) of INSPIRE participants and 36% (11 960/32 819) of study-eligible controls. Among initiators, 65% (514/790) of INSPIRE participants compared with 47% (5641/11 960) of controls achieved cure. In the matched analysis, enrolment in INSPIRE increased the odds of treatment initiation (OR: 5.25, 95% CI: 4.47-6.17) and cure (OR: 2.52, 95% CI: 2.00-3.16). Results from the sensitivity analyses showed agreement with the results from the full optimal match. Participation in the HCV care coordination programme significantly increased the probability of treatment initiation and cure, demonstrating that care coordination for HCV-infected individuals improves treatment outcomes.

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“…These trends may be reflective of other individual-level factors such as homelessness, substance abuse, and more fragmented care in general, among patients with multiple comorbid conditions. Furthermore, this more vulnerable group may have had seemingly higher retention in care as they may have returned to care more often for follow-up visits based on provider concerns about client health, fear of losing contact with the most transient clients, or based on receipt of more referrals to other clinics or specialists for their comorbid conditions [ 35 , 36 ]. However, while a higher proportion of these participants may have met the retention in care definition, their care patterns appear to reflect more disparate care, as meeting the definition did not translate into higher viral suppression.…”

Section: Discussionmentioning

confidence: 99%

Defining Care Patterns and Outcomes Among Persons Living with HIV in Washington, DC: Linkage of Clinical Cohort and Surveillance Data

Castel

Terzian

Opoku

et al. 2018

JMIR Public Health Surveill

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BackgroundTriangulation of data from multiple sources such as clinical cohort and surveillance data can help improve our ability to describe care patterns, service utilization, comorbidities, and ultimately measure and monitor clinical outcomes among persons living with HIV infection.ObjectivesThe objective of this study was to determine whether linkage of clinical cohort data and routinely collected HIV surveillance data would enhance the completeness and accuracy of each database and improve the understanding of care patterns and clinical outcomes.MethodsWe linked data from the District of Columbia (DC) Cohort, a large HIV observational clinical cohort, with Washington, DC, Department of Health (DOH) surveillance data between January 2011 and June 2015. We determined percent concordance between select variables in the pre- and postlinked databases using kappa test statistics. We compared retention in care (RIC), viral suppression (VS), sexually transmitted diseases (STDs), and non-HIV comorbid conditions (eg, hypertension) and compared HIV clinic visit patterns determined using the prelinked database (DC Cohort) versus the postlinked database (DC Cohort + DOH) using chi-square testing. Additionally, we compared sociodemographic characteristics, RIC, and VS among participants receiving HIV care at ≥3 sites versus <3 sites using chi-square testing.ResultsOf the 6054 DC Cohort participants, 5521 (91.19%) were included in the postlinked database and enrolled at a single DC Cohort site. The majority of the participants was male, black, and had men who have sex with men (MSM) as their HIV risk factor. In the postlinked database, 619 STD diagnoses previously unknown to the DC Cohort were identified. Additionally, the proportion of participants with RIC was higher compared with the prelinked database (59.83%, 2678/4476 vs 64.95%, 2907/4476; P<.001) and the proportion with VS was lower (87.85%, 2277/2592 vs 85.15%, 2391/2808; P<.001). Almost a quarter of participants (23.06%, 1279/5521) were identified as receiving HIV care at ≥2 sites (postlinked database). The participants using ≥3 care sites were more likely to achieve RIC (80.7%, 234/290 vs 62.61%, 2197/3509) but less likely to achieve VS (72.3%, 154/213 vs 89.51%, 1869/2088). The participants using ≥3 care sites were more likely to have unstable housing (15.1%, 64/424 vs 8.96%, 380/4242), public insurance (86.1%, 365/424 vs 57.57%, 2442/4242), comorbid conditions (eg, hypertension) (37.7%, 160/424 vs 22.98%, 975/4242), and have acquired immunodeficiency syndrome (77.8%, 330/424 vs 61.20%, 2596/4242) (all P<.001).ConclusionsLinking surveillance and clinical data resulted in the improved completeness of each database and a larger volume of available data to evaluate HIV outcomes, allowing for refinement of HIV care continuum estimates. The postlinked database also highlighted important differences between participants who sought HIV care at multiple clinical sites. Our findings suggest that combined datasets can enhance evaluation of HIV-related outcomes across an en...

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Effect of HIV Housing Services on Engagement in Care and Treatment, New York City, 2011

Cited by 28 publications

References 25 publications

HIV Treatment Cascade by Housing Status at Enrollment: Results from a Retention in Care Cohort

HIV Treatment Cascade by Housing Status at Enrollment: Results from a Retention in Care Cohort

Evaluation of a hepatitis C clinical care coordination programme’s effect on treatment initiation and cure: A surveillance‐based propensity score matching approach

Defining Care Patterns and Outcomes Among Persons Living with HIV in Washington, DC: Linkage of Clinical Cohort and Surveillance Data

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