Evidence map›Paper›PMID 42221367›Full record

ArticleOpen forum infectious diseases2026

Trends in HIV Viral Suppression in the POP-UP Low-Barrier Care Program for People With HIV Experiencing Homelessness or Unstable Housing.

Elizabeth Imbert, Lisa Fleming, Jon Oskarsson, Caycee Cullen, Mary Shiels, John Friend, Joi Jackson, Lindsay Felten, Negin Zahedikia, Francis Montgomery and 14 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open forum infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Elizabeth ImbertDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-3060-3596
Lisa FlemingDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Jon OskarssonDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Caycee CullenDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Mary ShielsDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
John FriendDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Joi JacksonDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Lindsay FeltenDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Negin ZahedikiaDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Francis MontgomeryAlliance Health Project, University of California, SanFrancisco, San Francisco, California, USA.
Liria SantosDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Francis Mayorga-MunozDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Yesenia RodriguezDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Yenifer BreganzaDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Janet GrochowskiDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Jennifer CohenDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Ayesha AppaDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-4602-5954
Kim KoesterCenter for AIDS Prevention Studies, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Xavier ErgueraDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-7632-0321
Edwin CharleboisCenter for AIDS Prevention Studies, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-7237-2119
Monica GandhiDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-7025-1994
Diane V HavlirDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.
Katerina ChristopoulosDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-8598-2191
Matthew D HickeyDivision of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-8913-1602

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Human immunodeficiency virus (HIV) viral suppression remains suboptimal among people with HIV (PWH) facing barriers such as homelessness, substance use, and mental health disorders. In 2019, Ward 86 launched the POP-UP program, a low-barrier HIV care model serving PWH with unstable housing and difficulty engaging in care. In 2021, we introduced long-acting antiretroviral therapy (LA-ART), including for PWH unable to attain viral suppression on oral antiretroviral therapy. This study evaluates temporal trends in viral suppression and mortality rates within the POP-UP program. Methods: We conducted a retrospective cohort study of PWH enrolled in the POP-UP program between August 2019 and December 2024. Eligibility included viremia (HIV viral load ≥200 copies/mL) or being off antiretroviral therapy, homelessness/unstable housing, and difficulty engaging in care. Criteria later expanded to include PWH with severe mental health or substance use disorders. The primary outcomes were viral suppression (<200 copies/mL) and death. Results: Among 241 PWH ever enrolled in POP-UP, 86% attained viral suppression at least once during follow-up. Cross-sectional viral suppression was 47% in August 2019 (8 months after program inception) and increased to 64% in December 2024. By December 2024, 46% of suppressed patients were on LA-ART. The mortality rate declined from 8.8/100 person-years in 2020 to 2.6/100 person-years in 2024, with reductions in both AIDS-related and overdose deaths. Conclusions: The POP-UP program improved viral suppression and may have reduced the mortality rate among PWH with substantial barriers to care. Improvements were likely driven by integration of LA-ART and continued quality improvement. Persistent viremia within the program highlights the need for additional strategies to address structural and psychosocial barriers.

Indexed as

HIVlong-acting antiretroviral therapylow-barrier care

Identifiers

PMID42221367
PMCPMC13218444

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