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Housing status and HIV risk behaviors among homeless and housed persons with HIV in the United States
Presented by Daniel Kidder, United States.
D. Kidder1, R. Wolitski2, S. Pals2, M. Campsmith2
1Centers for Disease Control and Prevention, Global AIDS Program, Atlanta, United States, 2Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, United States
Background: Homeless individuals are more likely than others to engage in HIV transmission risk behaviors. The challenges of homelessness are especially difficult for people living with HIV/AIDS (PLWHA). This study compares drug, alcohol, and sexual HIV transmission risk behaviors of homeless and housed PLWHA.
Methods: Data were from individual interviews with 8075 PLWHA (collected 2000-2003) through CDC’s Supplement to HIV/AIDS Surveillance (SHAS) project, a cross-sectional, multisite behavioral survey of adults newly diagnosed with HIV. Eligible persons were recruited from 19 US surveillance programs. Chi-square tests were used for categorical variables and t-tests for continuous variables to examine differences between homeless and housed PLWHA. Logistic regression examined effects of housing on sex, drug, and alcohol behaviors after controlling for potential confounding variables.
Results: At interview, 310 (4%) respondents were homeless (living in a shelter or on the streets). Compared to homeless respondents, housed respondents were more likely to have had sex in the past 12 months (c2=5.8, p<0.05). However, sexually active homeless respondents were more likely to have had >=10 sex partners during lifetime (c2=16.2, p<0.0001) and past 12 months (c2=16.9, p<0.0001), higher rate of sex exchange for money/drugs in lifetime (c2=103.0, p<0.0001) and past 12 months (c2=72.0, p<0.0001), and higher rate of unprotected sex with an unknown serostatus partner (OR=1.71, 95% CI=1.13, 2.60). Homeless respondents were more likely to have lifetime alcohol abuse (c2=49.7, p<0.0001), used drugs in the last 12 months (c2=88.1, p<0.0001), and injected drugs (lifetime [c2=62.8, p<0.0001], past 12 months [c2=64.5, p<0.0001]). In logistic regression analyses, housing status remained significantly associated with number of sex partners (past 12 months), sex exchange (lifetime and past 12 months), unprotected sex with unknown status partner, and all drug and alcohol use variables.
Conclusions: Cross-sectional findings indicated homeless PLWHA were more likely to engage in substance use and HIV transmission risk behaviors.
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