ArticleAIDS patient care and STDs2012
Homelessness as a structural barrier to effective antiretroviral therapy among HIV-seropositive illicit drug users in a Canadian setting.
Article in AIDS patient care and STDs, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
74 citing papers in PubMed, 7 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Tackling Inequalities in Access to Medicines for People Experiencing Homelessness: A Meta-Ethnography and Qualitative Systematic Review.Health expectations : an international journal of public participation in health care and health policy · 2024Pooled it
- Characteristics and Effectiveness of Co-Designed Mental Health Interventions in Primary Care for People Experiencing Homelessness: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- What treatment and services are effective for people who are homeless and use drugs? A systematic 'review of reviews'.PloS one · 2021Pooled it
- Pooled it
- Pooled it
- Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review.American journal of public health · 2016Pooled it
- Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis.Bulletin of the World Health Organization · 2015Pooled it
- A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam.International journal of STD & AIDS · 2022Trial
- Trial
- Antiretroviral utilization and adherence before vs. after expansion of a provincial drug insurance policy.AIDS (London, England) · 2026Article
- B/F/TAF forgiveness to non-adherence.Sexually transmitted infections · 2024Article
- Understanding the impact of a residential housing program for people living with HIV/AIDS: results from a realist evaluation.BMJ open · 2024Article
- Barriers to adherence to antiretroviral therapy: identifying priority areas for people with HIV and healthcare professionals.International journal of STD & AIDS · 2023Article
- Perceived Mistreatment in Health Care Settings and its Relationship with HIV Clinical Outcomes in HIV-positive People who Use Drugs in Vancouver, Canada.AIDS and behavior · 2023Article
- Adherence to antiretroviral therapy in people living with HIV with moderate or severe mental disorder.Scientific reports · 2023Article
- The Cannabis-Dependent Relationship Between Methadone Treatment Dose and Illicit Opioid Use in a Community-Based Cohort of People Who Use Drugs.Cannabis and cannabinoid research · 2023Article
- Periods of Homelessness Linked to Higher VACS Index Among HIV-Positive People Who Use Drugs.AIDS and behavior · 2022Article
- Assessing the determinants of completing OAT induction and long-term retention: A population-based study in British Columbia, Canada.Journal of substance abuse treatment · 2022Article
- Single Room Occupancy Residence: Processes Linking Housing to Not Engaging in HIV Outpatient Care.AIDS and behavior · 2021Article
- A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness.Campbell systematic reviews · 2021Review
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
Despite the advent of effective antiretroviral therapy (ART), HIV-seropositive injection drug users (IDU) continue to suffer from elevated levels of morbidity and mortality. Evidence is needed to identify social- and structural-level barriers to effective ART. We investigated the impact of homelessness on plasma HIV RNA response among illicit drug users initiating ART in a setting with free and universal access to HIV care. We accessed data from a long-running prospective cohort of community-recruited IDU linked to comprehensive HIV clinical monitoring and ART dispensation records. Using Cox proportional hazards with recurrent events modeling, we estimated the independent effect of homelessness on time to plasma HIV viral load suppression. Between May 1996 and September 2009, 247 antiretroviral naïve individuals initiated ART and contributed 1755 person-years of follow-up. Among these individuals, the incidence density of plasma HIV RNA suppression less than 500 copies/mm(3) was 56.7 (95% confidence interval [CI]: 46.9-66.0) per 100 person-years. In unadjusted analyses, homelessness was strongly associated with lower rates suppression (hazard ratio = 0.56, 95% CI: 0.40-0.78, p = 0.001), however, after adjustment for adherence this association was no longer significant (adjusted hazard ratio = 0.79, 95% CI: 0.56-1.11, p = 0.177). Homelessness poses a significant structural barrier to effective HIV treatment. However, since this relationship appears to be mediated by lower levels of ART adherence, interventions to improve adherence among members of this vulnerable population are needed.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.