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This study explores the impact of providing permanent housing and intensive case management to hospitalized HIV+ homeless patients on their survival with an intact immune system one year later. The findings show significant improvements in survival rates, CD4 counts, and HIV viral loads, highlighting the importance of housing stability in HIV treatment effectiveness.
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Chicago Housing for Health Partnership: HIV Outcomes David Buchanan MD MS, Romina Kee MD MPH, Laura Sadowski MD MPH, Diana Garcia MPH North American Housing & HIV/AIDS Research Summit June 4, 2009
What is the root cause of poor health among homeless patients? • Does homelessness lead to poor health? • Providing housing would improve health • Do other social factors lead to both poor health and homelessness? • Providing housing would not help much
Health Outcomes: Why HIV? • Top qualifying medical illness • Effective treatments for HIV exist • Housing stability may impact the effectiveness of HIV treatment • Markers for HIV Disease progression
HIV Outcomes: Hypothesis Providing permanent housing and intensive case management to hospitalized HIV+ homeless patients will improve their survival with an intact immune system one year later
HIV Outcomes: Methods • Inclusion: Enrolled at Stroger Hospital, HIV+ • 1 year later - CD4 count & Viral load • 1º Endpoint – Survival with intact immunity • Alive with CD4 > 200 and Viral Load < 100K • 2º Endpoints • CD4 Counts • HIV viral loads • Undetectable viral loads
HIV Outcomes – Data Sources • 105 Eligible (HIV+ Stroger Hosp enrollees) • 66 Visited Reference Lab or Died - 63% • 28 Labs - Outpatient usual care - 27% • 11 No labs & not deceased - 10%
Survival with intact immunity P = 0.04
CD4 (T Cell) Counts P = 0.23 Patients CD4 Counts - higher is better
HIV Viral Loads P = 0.03 for trend Patients Viral Loads - lower number is better
Viral Load (Mean) P = 0.03 MeanViral Load