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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.137810v1 99/S3/S675    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Buchanan, D. Articles by Garcia, D. Search for Related Content PubMed PubMed Citation Articles by Buchanan, D. Articles by Garcia, D. Related Collections Other Chronic Disease Epidemiology HIV/AIDS Homelessness Other Race/Ethnicity Other Statistics/Evaluation/Research

David Buchanan, MD, Romina Kee, MD, MPH, Laura S. Sadowski, MD, MPH and Diana Garcia, MPH

At the time of the study, David Buchanan, Romina Kee, and Laura S. Sadowski were at John Stroger Hospital of Cook County (formerly Cook County Hospital), Chicago, IL, and Rush University, Chicago. Diana Garcia was at John Stroger Hospital of Cook County, Chicago.

Correspondence: Requests for reprints should be sent to David Buchanan, Erie Family Health Center, 1701 W. Superior, Chicago, IL 60622 (e-mail: dbuchanan{at}eriefamilyhealth.org).

Objectives. We assessed the health impact of a housing and case management program, the Chicago Housing for Health Partnership, for homeless people with HIV.

Methods. HIV-positive homeless inpatients at a public hospital (n = 105) were randomized to usual care or permanent housing with intensive case management. The primary outcome was survival with intact immunity, defined as CD4 count 200 and viral load < 100 000. Secondary outcomes were viral loads, undetectable viral loads, and CD4 counts.

Results. Outcomes were available for 94 of 105 enrollees (90%). Of 54 intervention participants, 35 (65%) reached permanent housing in program housing agencies. After 1 year, 55% of the intervention and 34% of the usual care groups were alive and had intact immunity (P = .04). Seventeen intervention (36%) and 9 usual care (19%) participants had undetectable viral loads (P = .051). Median viral loads were 0.89 log lower in the intervention group (P = .03). There were no statistical differences in CD4 counts.

Conclusions. Homelessness is a strong predictor of poor health outcomes and complicates the medical management of HIV. This housing intervention improved the health of HIV-positive homeless people.