HIV infection has become a chronic condition that for most persons can be effectively managed with regular monitoring and appropriate medical care. However, many HIV positive persons remain unconnected to medical care or have less optimal patterns of health care utilization than recommended by good clinical practice standards. This paper investigates housing status as a contextual factor affecting access and maintenance in appropriate HIV medical care. Data provided from 5,881 interviews conducted from 1994 to 2006 with a representative sample of 1,661 persons living with HIV/AIDS in New York City demonstrated a strong and consistent relationship between housing need and remaining outside of or marginal to HIV medical care. In contrast, housing assistance increased access and retention in medical care and appropriate treatment. The relationship between housing and medical care outcomes remain controlling for client demographics, health status, insurance coverage, co-occurring mental illness, and problem drug use and the receipt of supportive services to address co-occurring conditions. Findings provide strong evidence that housing needs are a significant barrier to consistent, appropriate HIV medical care, and that receipt of housing assistance has an independent, direct impact on improved medical care outcomes.
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Acknowledgments The CHAIN Project provides systematic data from the perspective of persons living with HIV used for policy and program planning by the Health and Human Services Planning Council of New York and the NY Department of Health and Mental Hygiene Office of AIDS Policy and Community Planning. A Technical Review Team (TRT) provides oversight for the CHAIN Project. In addition to Peter Messeri, Ph.D. and Angela Aidala, Ph.D. of Columbia University’s Mailman School of Public Health, current members include Mary Ann Chiasson, DrPH, MHRA (chair); Lucia Torian, Ph.D., NYCDOHMH; Jan Carl Park, MPA, Nina Rothschild, DrPH, Office of AIDS Policy and Community Planning; Clarissa Silva, MSW, and Daniel Weglein, MD, Office of Evaluation and Quality Assurance, JoAnn Hilger, NYCDOHMH; Julie Lehane, Ph.D., Westchester County DOH; Roberta Scheinmann, MPH, MHRA. This research was supported by grant number H89 HA 0015– 15 from the US Health Resources and Services Administration (HRSA), HIV/AIDS Bureau with the support of the HIV Health and Human Services Planning Council, through the New York City Department of Health and Mental Hygiene and the Medical and Health Research Association of New York City Inc. Its contents are solely the responsibility of the researchers and do not necessarily represent the official views of the US Health Resources and Services Administration, the City of New York, or the Medical and Health Research Association of New York.
- Medical care
- Socioeconomic factors