Homelessness and residential instability as covariates of HIV risk behavior among residents of single room occupancy housing

Bowen, Elizabeth A.; Mitchell, C G B

doi:10.1080/15381501.2015.1123210

Cited by 6 publications

(4 citation statements)

References 35 publications

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“…National estimates of the number of people in the U.S. experiencing homelessness showed an 8.7% increase from 2018 to 2019; driven by the number of unsheltered people who are homeless (U.S. Department of Housing and Urban Development Office of Community Planning and Development, 2020). Housing instability is associated with increased HIV morbidity and mortality, and poor health outcomes (Aidala et al, 2016;Bowen & Mitchell, 2016;Milloy et al, 2012). Moreover, there is a bidirectional relationship between homelessness and substance use disorders with disputable evidence regarding causation (Linton et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

HIV Injection Risk Behaviors among HIV-Negative People Who Inject Drugs Experiencing Homelessness, 23 U.S. Cities

Marcus

Cha

Sionéan

et al. 2021

Journal of Social Distress and Homelessness

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Despite recent declines in numbers of people who inject drugs (PWID) diagnosed with HIV, clusters of HIV among PWID are ongoing, especially among PWID experiencing homelessness. Using data from the National HIV Behavioral Surveillance in 2018, we evaluated the association between homelessness and injection risk and prevention behaviors among HIV-negative PWID who were recruited by respondent-driven sampling in 23 U.S. cities. Interviewers assessed sociodemographic characteristics, history of overdose, and behavioral risk and prevention factors for HIV. Adjusted prevalence ratios (aPR) and 95% CI were obtained using Poisson regression models. Of 10,614 HIV-negative PWID participants, 7275 (68.5%) reported experiencing homelessness. Homeless PWID were more likely than those who were not to be younger age, white, unemployed, without health insurance, in poverty, experiencing psychological distress, and incarcerated in the past 12 months. PWID experiencing homelessness were significantly more likely to report injection risk behaviors [share syringes/equipment (aPR = 1.26; 95% CI = 1.20-1.33), non-fatal opioid overdose (aPR = 1.64; 95% CI = 1.49-1.79)] and prevention behaviors [testing for HIV in past 12 months (aPR = 1.18; 95% CI = 1.12-1.24) and using syringe services programs (aPR = 1.09; 95% CI = 1.03-1.16)] than PWID not experiencing homelessness. Homelessness among PWID is associated with injection risk behaviors and non-fatal overdose.

show abstract

Section: Introductionmentioning

confidence: 99%

HIV Injection Risk Behaviors among HIV-Negative People Who Inject Drugs Experiencing Homelessness, 23 U.S. Cities

Marcus

Cha

Sionéan

et al. 2021

Journal of Social Distress and Homelessness

View full text Add to dashboard Cite

show abstract

“…Nationwide, approximately 9.5% of people living with HIV (PLWH) experienced homelessness in 2018 (Centers for Disease Control and Prevention [CDC], 2020). PLWH who are experiencing homelessness have worse HIV outcomes, including poorer retention in care, lower adherence to antiretroviral treatment (ART), higher viral load (Aidala et al, 2016; Bowen & Mitchell, 2016; Milloy et al, 2012; Rajabiun et al, 2018), and a greater likelihood of death (Schwarcz et al, 2009). People who experience social determinants of poor health, such as poverty, unemployment, lack of health care coverage, history of incarceration, and stigma, are more likely to experience housing instability than people who do not experience social determinants of poor health (Aidala et al, 2016; Baugher et al, 2017; Davila et al, 2018).…”

mentioning

confidence: 99%

Characteristics of Adults With Diagnosed HIV Who Experienced Housing Instability: Findings From the Centers for Disease Control and Prevention Medical Monitoring Project, United States, 2018

Marcus¹,

Tie²,

Dasgupta³

et al. 2021

J Assoc Nurses AIDS Care

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People living with HIV (PLWH) who experience homelessness have poorer clinical outcomes than people with HIV who are not homeless; however, there is limited information on PLWH who experience other forms of housing instability. We used interviews and medical record abstraction data from the Medical Monitoring Project, collected 2018–2019 (N = 4,050), to describe sociodemographic characteristics and clinical outcomes of adults with HIV by whether people experienced unstable housing in the past 12 months. Overall, 21% were unstably housed, of which 55.2% were unstably housed but not homeless. People who were unstably housed were more likely to be younger, have lower educational attainment, be previously incarcerated, live at or below the poverty level, and have poorer mental health and clinical outcomes, independent of homelessness. Interventions to address housing instability, integrated with clinical care, could benefit not just PLWH who are homeless but also those who are unstably housed.

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“…Syndemic theory posits that conditions, such as structural, social, and individual-level factors, are mutually reinforcing and interact leading to adverse health outcomes (see Figure 1) [16,17]. Previous studies found that housing insecurity, such as a lack of access, affordability, and homelessness were related to IPV [18][19][20], substance use [16,21,22], and factors that increased one's risk of acquiring HIV [23][24][25][26]. There is a dearth of research that has explored housing among BLCW through a syndemics lens.…”

Section: Syndemic Modelmentioning

confidence: 99%

Housing Insecurity and Other Syndemic Factors Experienced by Black and Latina Cisgender Women in Austin, Texas: A Qualitative Study

Nydegger,

Benton,

Hemingway

et al. 2023

IJERPH

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Austin, Texas emerged as one of the fastest-growing cities in the U.S. over the past decade. Urban transformation has exacerbated inequities and reduced ethnic/racial diversity among communities. This qualitative study focused on housing insecurity and other syndemic factors among Black and Latina cisgender women (BLCW). Data collection from 18 BLCW using in-depth interviews guided by syndemic theory was conducted three times over three months between 2018 and 2019. Four housing insecurity categories emerged: (a) very unstable, (b) unstable, (c) stable substandard, and (d) stable costly. Participants who experienced more stable housing, particularly more stable housing across interviews, reported fewer instances of intimate partner violence (IPV), less substance use, and a reduced risk of acquiring HIV. Results identified the importance of exploring housing insecurity with other syndemic factors among BLCW along with determining structural- and multi-level interventions to improve housing circumstances and other syndemic factors. Future research should explore these factors in other geographic locations, among other intersectional communities, and among larger sample sizes and consider using a mixed methods approach.

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Homelessness and residential instability as covariates of HIV risk behavior among residents of single room occupancy housing

Cited by 6 publications

References 35 publications

HIV Injection Risk Behaviors among HIV-Negative People Who Inject Drugs Experiencing Homelessness, 23 U.S. Cities

HIV Injection Risk Behaviors among HIV-Negative People Who Inject Drugs Experiencing Homelessness, 23 U.S. Cities

Characteristics of Adults With Diagnosed HIV Who Experienced Housing Instability: Findings From the Centers for Disease Control and Prevention Medical Monitoring Project, United States, 2018

Housing Insecurity and Other Syndemic Factors Experienced by Black and Latina Cisgender Women in Austin, Texas: A Qualitative Study

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