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Lightner JS, Chesnut S, Cabral HJ, Myers JJ, Brooks RA, Byrne T, Rajabiun S. Advancing Patient Navigation for HIV: Evaluating Models of Care for Housing and Employment. AIDS Behav 2024:10.1007/s10461-024-04464-2. [PMID: 39172185 DOI: 10.1007/s10461-024-04464-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 08/23/2024]
Abstract
People with HIV face challenges securing housing and employment. Patient navigation is an effective intervention that can improve the receipt of these services, which have been linked to better health outcomes. The purpose of this study was to assess implementation of patient navigation in diverse delivery settings. We also evaluated the relationship between these services and health outcomes among participants. Twelve sites in the United States (N = 1,082) implemented navigation using single or multiple navigator interventions to improve housing, employment, viral suppression, and retention in care. Sites included health departments, health centers, and AIDS service organizations (ASO). Client-level data were used to model relationships of interest. Across the 12 sites, regardless of model, housing (odds ratio (OR) = 1.18, p < .001), employment (OR = 1.09, p < .001) and retention in care (OR 1.11, p = .007) improved significantly over time; however, viral suppression did not (OR = 1.04, p = .120). Regardless of model of care, patient navigation improved housing, employment, and retention in care. This study demonstrated that while navigation supports people with HIV in securing housing and employment, models using a more intensive format worked best in specific settings. While most studies focus on unimodal strategies, this study builds on the evidence by examining how navigation models can be delivered to reduce barriers to care.
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Affiliation(s)
- Joseph S Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA.
| | - Steven Chesnut
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Howard J Cabral
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| | - Janet J Myers
- Division of Prevention Science, University of California, San Francisco, San Francisco, CA, USA
| | - Ronald A Brooks
- Center for HIV Identification, Prevention, and Treatment, University of California-Los Angeles, Los Angeles, CA, USA
| | - Thomas Byrne
- Center for Innovation in Social Work and Health, School of Social Work, Boston University, Boston, MA, USA
| | - Serena Rajabiun
- Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Mars SG, Spinelli MA, Ondocsin J, Koester KA, Rodriguez ES, Jain J, Arreguin M, Johnson MO, Gandhi M. Pandemic expertise: qualitative findings on the experiences of living with HIV during the COVID-19 pandemic. AIDS Care 2024; 36:382-389. [PMID: 37621106 PMCID: PMC10891295 DOI: 10.1080/09540121.2023.2248579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
This qualitative study explored the experiences of people living with HIV (PLWH) in the San Francisco Bay Area, United States, during the COVID-19 pandemic and subsequent public health restrictions at a safety net HIV clinic. Patients (N = 30) were recruited for Spanish/English language semi-structured interviews (n = 30), translated when necessary, and analyzed thematically. The recurring theme of "pandemic expertise" emerged from the data: skills and attitudes developed through living with HIV helped PLWH cope with the COVID-19 pandemic, including effective strategies for dealing with anxiety and depression; appreciation for life; and practical experience of changing behavior to protect their health. A subset did not consider living with HIV helped them adapt to the COVID-19 pandemic, with some describing their lives as chaotic due to housing issues and/or ongoing substance use. Overall, interviewees reported finding trustworthy health information that helped them follow COVID-19 prevention strategies. Although living with HIV is associated with a higher prevalence of mental health concerns, substance use, and stigma, these challenges can also contribute to increased self-efficacy, adaptation, and resilience. Addressing structural issues such as housing appears to be key to responding to both pandemics.
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Affiliation(s)
- Sarah G Mars
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Matthew A Spinelli
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Jeff Ondocsin
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Kim A Koester
- Department of Medicine, University of California, San Francisco, CA, USA
| | | | - Jennifer Jain
- Department of Psychiatry and Behavior Sciences, University of California, San Francisco, CA, USA
| | - Mireya Arreguin
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Mallory O Johnson
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Monica Gandhi
- Department of Medicine, University of California, San Francisco, CA, USA
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Shacham E, Scroggins SE, Ellis M. Implementing Geospatial Science and Technology to Get to Zero New HIV Infections. Curr HIV/AIDS Rep 2023; 20:139-147. [PMID: 37145264 DOI: 10.1007/s11904-023-00658-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE OF REVIEW Tremendous advancements have been made in HIV treatment and prevention during the last 40 years that zero new HIV cases has become an attainable goal declared by international agencies. However, new cases of HIV infection persist. RECENT FINDINGS The emerging field of geospatial science is positioned to play key role in the reduction of continued HIV incidence through technology-driven interventions and innovative research that gives insights into at-risk populations. As these methods become more utilized, findings consistently show the important role of location and environment plays in HIV incidence and treatment adherence. This includes distance to HIV provider, locations of where HIV transmissions occurs compared to where people with HIV reside, and how geospatial technology has been leveraged to identify unique insights among varying groups of those at increased risk for HIV, among others. Given these insights, leveraging geospatial technology would play a prominent role in achieving zero new cases of HIV infections.
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Affiliation(s)
- Enbal Shacham
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA.
- Taylor Geospatial Institute, St. Louis, MO, USA.
| | | | - Matthew Ellis
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO, USA
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Imbert E, Hickey MD, Del Rosario JB, Conte M, Kerkoff AD, Clemenzi-Allen A, Riley ED, Havlir DV, Gandhi M. Brief Report: Heterogeneous Preferences for Care Engagement Among People With HIV Experiencing Homelessness or Unstable Housing During the COVID-19 Pandemic. J Acquir Immune Defic Syndr 2022; 90:140-145. [PMID: 35262529 PMCID: PMC9203876 DOI: 10.1097/qai.0000000000002929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND/SETTING In San Francisco, HIV viral suppression is 71% among housed individuals but only 20% among unhoused individuals. We conducted a discrete choice experiment at a San Francisco public HIV clinic to evaluate care preferences among people living with HIV (PLH) experiencing homelessness/unstable housing during the COVID-19 pandemic. METHODS From July to November 2020, we conducted a discrete choice experiment among PLH experiencing homelessness/unstable housing who accessed care through (1) an incentivized, drop-in program (POP-UP) or (2) traditional primary care. We investigated 5 program features: single provider vs team of providers; visit incentives ($0, $10, and $20); location (current site vs current + additional site); drop-in vs scheduled visits; in-person only vs optional telehealth visits; and navigator assistance. We estimated relative preferences using mixed-effects logistic regression and conducted latent class analysis to evaluate preference heterogeneity. RESULTS We enrolled 115 PLH experiencing homelessness/unstable housing, 40% of whom lived outdoors. The strongest preferences were for the same provider (β = 0.94, 95% CI: 0.48 to 1.41), visit incentives (β = 0.56 per $5; 95% CI: 0.47 to 0.66), and drop-in visits (β = 0.47, 95% CI: 0.12 to 0.82). Telehealth was not preferred. Latent class analysis revealed 2 distinct groups: 78 (68%) preferred a flexible care model, whereas 37 (32%) preferred a single provider. CONCLUSIONS We identified heterogeneous care preferences among PLH experiencing homelessness/unstable housing during the COVID-19 pandemic, with two-thirds preferring greater flexibility and one-third preferring provider continuity. Telehealth was not preferred, even with navigator facilitation. Including patient choice in service delivery design can improve care engagement, particularly for marginalized populations, and is an essential tool for ending the HIV epidemic.
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Affiliation(s)
- Elizabeth Imbert
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
| | - Matthew D. Hickey
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
| | - Jan Bing Del Rosario
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
| | - Madellena Conte
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
| | - Andrew D. Kerkoff
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
| | - Angelo Clemenzi-Allen
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
- San Francisco Department of Public Health, San Francisco, USA
| | - Elise D Riley
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
| | - Diane V. Havlir
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
| | - Monica Gandhi
- Division of HIV, ID and Global Medicine, University of California, San Francisco, USA
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Marcus R, Tie Y, Dasgupta S, Beer L, Padilla M, Fagan J, Prejean J. Characteristics of Adults With Diagnosed HIV Who Experienced Housing Instability: Findings From the Centers for Disease Control and Prevention Medical Monitoring Project, United States, 2018. J Assoc Nurses AIDS Care 2022; 33:283-294. [PMID: 34812797 PMCID: PMC9124455 DOI: 10.1097/jnc.0000000000000314] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT People living with HIV (PLWH) who experience homelessness have poorer clinical outcomes than people with HIV who are not homeless; however, there is limited information on PLWH who experience other forms of housing instability. We used interviews and medical record abstraction data from the Medical Monitoring Project, collected 2018-2019 (N = 4,050), to describe sociodemographic characteristics and clinical outcomes of adults with HIV by whether people experienced unstable housing in the past 12 months. Overall, 21% were unstably housed, of which 55.2% were unstably housed but not homeless. People who were unstably housed were more likely to be younger, have lower educational attainment, be previously incarcerated, live at or below the poverty level, and have poorer mental health and clinical outcomes, independent of homelessness. Interventions to address housing instability, integrated with clinical care, could benefit not just PLWH who are homeless but also those who are unstably housed.
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Affiliation(s)
- Ruthanne Marcus
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yunfeng Tie
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharoda Dasgupta
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Linda Beer
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mabel Padilla
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Fagan
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joseph Prejean
- Behavioral and Clinical Surveillance Branch, Division of HIV Prevention, National Center for HIV/ AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Rodriguez-Diaz CE, Davis W, Ellis MV, Cameron MS, Donastorg Y, Bowleg L, Greenberg A, Kerrigan D. Disrupting the Systems: Opportunities to Enhance Methodological Approaches to Address Socio-Structural Determinants of HIV and End the Epidemic Through Effective Community Engagement. AIDS Behav 2021; 25:225-231. [PMID: 34618266 PMCID: PMC8494756 DOI: 10.1007/s10461-021-03475-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/12/2022]
Abstract
A world without HIV is only possible by addressing the socio-structural determinants of health. Our understanding of socio-structural determinants is constantly changing, and parallel changes must occur with the methodologies used to explain the drivers of the HIV epidemic. We argue for the need to engage communities in the planning, implementation, and dissemination of research on the socio-structural determinants of HIV. Community engagement should cross-cut various types of research including rigorous measurement development of socio-structural determinants and novel analytic techniques to model their role in the trajectory of the epidemic and the impact of interventions. Considering the role of place, we recommend collaboration between scientists and communities in the interpretation of results from studies that map HIV-related behaviors and movement. As we collectively delve into historically oppressive systems with colonial antecedents, we must be ready to challenge these systems and replace them with collaborative models. The success of research-driven HIV policy and programming will best be evaluated with methodologies derived from the insights of the very individuals that these policies and programs aim to serve.
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Affiliation(s)
- Carlos E Rodriguez-Diaz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washigton University, 950 New Hampshire Ave NW, Suite 300, Washington, DC, 20052, USA.
- DC Center for AIDS Research, Washington, USA.
| | - Wendy Davis
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washigton University, 950 New Hampshire Ave NW, Suite 300, Washington, DC, 20052, USA
- DC Center for AIDS Research, Washington, USA
| | | | | | - Yeycy Donastorg
- Instituto Dermatológico y Cirugia de Piel, Santo Domingo, Dominican Republic
| | - Lisa Bowleg
- DC Center for AIDS Research, Washington, USA
- Department of Psychology and Brain Sciences, George Washington University, Washington, USA
| | - Alan Greenberg
- DC Center for AIDS Research, Washington, USA
- Department of Epidemiology, George Washington University-Milken Institute School of Public Health, Washington, USA
| | - Deanna Kerrigan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washigton University, 950 New Hampshire Ave NW, Suite 300, Washington, DC, 20052, USA
- DC Center for AIDS Research, Washington, USA
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Imbert E, Hickey MD, Clemenzi-Allen A, Lynch E, Friend J, Kelley J, Conte M, Das D, Del Rosario JB, Collins E, Oskarsson J, Hicks ML, Riley ED, Havlir DV, Gandhi M. Evaluation of the POP-UP programme: a multicomponent model of care for people living with HIV with homelessness or unstable housing. AIDS 2021; 35:1241-1246. [PMID: 34076613 PMCID: PMC8186736 DOI: 10.1097/qad.0000000000002843] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Homelessness is the greatest risk factor for HIV viremia in San Francisco. Innovative care models for people with HIV (PWH) with homelessness or unstable housing (HUH) are needed to address this inequity. We developed a novel low-barrier clinic-based program for PWH-HUH in an urban safety-net clinic ('POP-UP') and report outcomes on care engagement and viral suppression. DESIGN A prospective cohort study. SETTING San Francisco General Hospital HIV Clinic (Ward 86). PARTICIPANTS We enrolled PWH who are HUH, viraemic and for whom usual care is not working (at least one missed primary care appointment and at least two drop-in visits at Ward 86 in the last year). INTERVENTION POP-UP provides drop-in comprehensive primary care, housing assistance and case management, financial incentives and patient navigation with frequent contact. MAIN OUTCOME MEASURES We describe uptake of eligible patients into POP-UP, and cumulative incidence of antiretroviral therapy (ART) initiation, return to care and virologic suppression 6 months post-enrolment, estimated via Kaplan--Meier. RESULTS Out of 192 referred patients, 152 were eligible, and 75 enrolled. All 75 were off ART and viraemic; 100% had a substance use disorder; and 77% had a mental health diagnosis. Over three-quarters restarted ART within 7 days of enrolment, and 91% returned for follow-up within 90 days. The cumulative incidence of viral suppression at 6 months was 55% (95% confidence interval 43-68). CONCLUSION A novel care model for PWH-HUH demonstrates early success in engaging viraemic patients in care and improving viral suppression. Low-barrier, high-contact primary care programmes offering comprehensive services and incentives may improve outcomes for this vulnerable population.
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Affiliation(s)
- Elizabeth Imbert
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Matthew D. Hickey
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Angelo Clemenzi-Allen
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
- San Francisco Department of Public Health
| | - Elizabeth Lynch
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - John Friend
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Jackelyn Kelley
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | | | | | - Jan Bing Del Rosario
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Erin Collins
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Jon Oskarsson
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Mary Lawrence Hicks
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Elise D. Riley
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Diane V. Havlir
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
| | - Monica Gandhi
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco
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Riley ED, Hickey MD, Imbert E, Clemenzi-Allen AA, Gandhi M. Coronavirus Disease 2019 (COVID-19) and HIV Spotlight the United States Imperative for Permanent Affordable Housing. Clin Infect Dis 2021; 72:2042-2043. [PMID: 32887980 PMCID: PMC7499525 DOI: 10.1093/cid/ciaa1327] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022] Open
Abstract
Job loss and evictions tied to the COVID-19 pandemic are expected to significantly increase homelessness in the coming months. Reciprocally, homelessness and the many vulnerabilities that inevitably accompany it are driving COVID-19 outbreaks in U.S. shelters and other congregate living situations. Unless we intervene to address homelessness, these co-existing and synergistic situations will make the current public health crisis even worse. Preventing homelessness and providing permanent affordable housing has reduced the ravages of the HIV epidemic. We must take the lessons learned in 40 years of fighting HIV to respond effectively to the COVID-19 crisis. Housing is an investment that will curb the spread of COVID-19 and help protect all of us from future pandemics.
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Affiliation(s)
- Elise D Riley
- Department of Medicine, Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Matthew D Hickey
- Department of Medicine, Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth Imbert
- Department of Medicine, Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Angelo A Clemenzi-Allen
- Department of Medicine, Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA.,San Francisco Department of Public Health, San Francisco, California, USA
| | - Monica Gandhi
- Department of Medicine, Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA
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Conte M, Eshun-Wilson I, Geng E, Imbert E, Hickey MD, Havlir D, Gandhi M, Clemenzi-Allen A. Brief Report: Understanding Preferences for HIV Care Among Patients Experiencing Homelessness or Unstable Housing: A Discrete Choice Experiment. J Acquir Immune Defic Syndr 2020; 85:444-449. [PMID: 33136742 PMCID: PMC8028840 DOI: 10.1097/qai.0000000000002476] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Homelessness and unstable housing (HUH) negatively impact care outcomes for people living with HIV (PLWH). To inform the design of a clinic program for PLWH experiencing HUH, we quantified patient preferences and trade-offs across multiple HIV-service domains using a discrete choice experiment (DCE). METHODS We sequentially sampled PLWH experiencing HUH presenting at an urban HIV clinic with ≥1 missed primary care visit and viremia in the last year to conduct a DCE. Participants chose between 2 hypothetical clinics varying across 5 service attributes: care team "get to know me as a person" versus not; receiving $10, $15, or $20 gift cards for clinic visits; drop-in versus scheduled visits; direct phone communication to care team versus front-desk staff; and staying 2 versus 20 blocks from the clinic. We estimated attribute relative utility (ie, preference) using mixed-effects logistic regression and calculated the monetary trade-off of preferred options. RESULTS Among 65 individuals interviewed, 61% were >40 years old, 45% White, 77% men, 25% heterosexual, 56% lived outdoors/emergency housing, and 44% in temporary housing. Strongest preferences were for patient-centered care team [β = 3.80; 95% confidence interval (CI): 2.57 to 5.02] and drop-in clinic appointments (β = 1.33; 95% CI: 0.85 to 1.80), with a willingness to trade $32.79 (95% CI: 14.75 to 50.81) and $11.45 (95% CI: 2.95 to 19.95) in gift cards/visit, respectively. CONCLUSIONS In this DCE, PLWH experiencing HUH were willing to trade significant financial gain to have a personal relationship with and drop-in access to their care team rather than more resource-intensive services. These findings informed Ward 86's "POP-UP" program for PLWH-HUH and can inform "ending the HIV epidemic" efforts.
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Affiliation(s)
- Madellena Conte
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
- Institute of Global Health Sciences, University of California, San Francisco, San Francisco, CA
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Ingrid Eshun-Wilson
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO; and
| | - Elvin Geng
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO; and
| | - Elizabeth Imbert
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Matthew D Hickey
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Diane Havlir
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Monica Gandhi
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Angelo Clemenzi-Allen
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
- San Francisco Department of Public Health, San Francisco, CA
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