ArticleAIDS (London, England)2016
The population impact of eliminating homelessness on HIV viral suppression among people who use drugs.
Article in AIDS (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis 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
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Influence of Material Deprivation on Clinical Outcomes Among People Living with HIV in High-Income Countries: A Systematic Review and Meta-analysis.AIDS and behavior · 2022Pooled it
- The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada.BMC public health · 2022Article
- Periods of Homelessness Linked to Higher VACS Index Among HIV-Positive People Who Use Drugs.AIDS and behavior · 2022Article
- Article
- Ranking evidence in substance use and addiction.The International journal on drug policy · 2020Article
- Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study.The International journal on drug policy · 2019Article
- HIV Treatment Cascade by Housing Status at Enrollment: Results from a Retention in Care Cohort.AIDS and behavior · 2019Article
- Longitudinal Determinants of Housing Stability Among People Living With HIV/AIDS Experiencing Homelessness.American journal of public health · 2018Article
- Social and structural factors associated with greater time with a plasma HIV-1 RNA viral load above log10(1500) copies/ml among illicit drug users.AIDS (London, England) · 2018Article
- Place-Based Predictors of HIV Viral Suppression and Durable Suppression Among Men Who Have Sex With Men in New York City.AIDS and behavior · 2017Article
- Integrated HIV care and service engagement among people living with HIV who use drugs in a setting with a community-wide treatment as prevention initiative: a qualitative study in Vancouver, Canada.Journal of the International AIDS Society · 2017Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveWe sought to estimate the change in viral suppression prevalence if homelessness were eliminated from a population of HIV-infected people who use drugs.
designCommunity-recruited prospective cohort of HIV-infected people who use drugs in Vancouver, Canada. Behavioural information was collected at baseline and linked to a province-wide HIV/AIDS treatment database. The primary outcome was viral suppression (<50 copies/ml) measured during subsequent routine clinical care.
methodsWe employed an imputation-based marginal modelling approach. First, we used modified Poisson regression to estimate the relationship between homelessness and viral suppression (adjusting for sociodemographics, substance use, addiction treatment, and other confounders). Then, we imputed an outcome probability for each individual while manipulating the exposure (homelessness). Population viral suppression prevalence under realized and 'housed' scenarios were obtained by averaging these probabilities across the study population. Bootstrapping was conducted to calculate 95% confidence limits.
resultsOf 706 individuals interviewed between January 2005 and December 2013, the majority were men (66.0%), of white race/ethnicity (55.1%), and had a history of injection drug use (93.6%). At first study visit, 223 (31.6%) reported recent homelessness, and 37.8% were subsequently identified as virally suppressed. Adjusted marginal models estimated a 15.1% relative increase [95% confidence interval (CI) 9.0-21.7%) in viral suppression in the entire population - to 43.5% (95% CI 39.4-48.2%) - if all homeless individuals were housed. Among those homeless, eliminating this exposure would increase viral suppression from 22.0 to 40.1% (95% CI 35.1-46.1%), an 82.3% relative increase.
conclusionInterventions to house homeless, HIV-positive individuals who use drugs could significantly increase population viral suppression. Such interventions should be implemented as a part of renewed HIV/AIDS prevention and treatment efforts.
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