Impact of housing on the survival of persons with AIDSReport as inadecuate

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BMC Public Health

, 9:220

First Online: 07 July 2009Received: 25 November 2008Accepted: 07 July 2009DOI: 10.1186-1471-2458-9-220

Cite this article as: Schwarcz, S.K., Hsu, L.C., Vittinghoff, E. et al. BMC Public Health 2009 9: 220. doi:10.1186-1471-2458-9-220


BackgroundHomeless persons with HIV-AIDS have greater morbidity and mortality, more hospitalizations, less use of antiretroviral therapy, and worse medication adherence than HIV-infected persons who are stably housed. We examined the effect of homelessness on the mortality of persons with AIDS and measured the effect of supportive housing on AIDS survival.

MethodsThe San Francisco AIDS registry was used to identify homeless and housed persons who were diagnosed with AIDS between 1996 and 2006. The registry was computer-matched with a housing database of homeless persons who received housing after their AIDS diagnosis. The Kaplan-Meier product limit method was used to compare survival between persons who were homeless at AIDS diagnosis and those who were housed. Proportional hazards models were used to estimate the independent effects of homelessness and supportive housing on survival after AIDS diagnosis.

ResultsOf the 6,558 AIDS cases, 9.8% were homeless at diagnosis. Sixty-seven percent of the persons who were homeless survived five years compared with 81% of those who were housed p < 0.0001. Homelessness increased the risk of death adjusted relative hazard RH 1.20; 95% confidence limits CL 1.03, 1.41. Homeless persons with AIDS who obtained supportive housing had a lower risk of death than those who did not adjusted RH 0.20; 95% CL 0.05, 0.81.

ConclusionSupportive housing ameliorates the negative effect of homelessness on survival with AIDS.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-9-220 contains supplementary material, which is available to authorized users.

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Author: Sandra K Schwarcz - Ling C Hsu - Eric Vittinghoff - Annie Vu - Joshua D Bamberger - Mitchell H Katz


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