HIV/AIDS, Housing Problems
Conditions
Keywords
HIV, housing, homelessness
Brief summary
Randomized controlled trial of housing placement assistance for homeless persons with HIV
Detailed description
Approximately 800 persons living with HIV/AIDS (PLWHA) reside in HIV emergency single-room-occupancy (SRO) hotels in New York City and do not have the ability to secure permanent housing on their own. The study evaluated a pilot program which fast-tracked PLWHA from HIV emergency SRO hotels into permanent housing. The Enhanced Housing Placement Assistance (EHPA) program had three components: 1) active recruitment of emergency SRO hotel residents with high need for housing; 2) assistance in the rapid (fast-track) acquisition of permanent housing; and 3) participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability. Participants were randomly assigned to either 1) EHPA or 2) usual care, which included standard connections to services and housing programs offered by the New York City HIV/AIDS Services Administration (HASA), Housing Opportunities for Persons With AIDS (HOPWA), or Ryan White services, and were followed over twelve months using a questionnaire developed with significant input from the target population of PLWHA residing in emergency SRO hotels.
Interventions
OTHEREnhanced housing placement assistance
assistance in the rapid (fast-track) acquisition of permanent housing; and participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability
OTHERStandard housing placement assistance
standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White
Sponsors
New York City Department of Health and Mental Hygiene
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Person living with HIV in New York City * Residing in an New York City HASA single-adult single-room-occupancy (SRO) hotel
Exclusion criteria
* Inability to provide informed consent * Inability to complete survey in English or Spanish
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Placement in Permanent Housing | 12 months post-enrollment | supportive housing, rental assistance, other non-emergency housing, etc. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Engagement in HIV Care | 12 months post-enrollment | any reported HIV viral load (VL) or CD4 test |
| Number of Participants With HIV Viral Suppression | 12 months post-enrollment | Last viral load is under 200 copies/mL |
Participant flow
Recruitment details
The study team recruited participants onsite at 22 HIV emergency single adult shelters across NYC between April 2012 and April 2013
Participants by arm
| Arm | Count |
|---|---|
| Enhanced Housing Placement Assistance Enhanced housing placement assistance: assistance in the rapid (fast-track) acquisition of permanent housing; and participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability | 119 |
| Standard Housing Placement Assistance Standard housing placement assistance: standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White | 117 |
| Total | 236 |
Baseline characteristics
| Characteristic | Standard Housing Placement Assistance | Total | Enhanced Housing Placement Assistance |
|---|---|---|---|
| Age, Continuous | 48 years | 48 years | 48 years |
| Engagement in HIV Care | 117 Participants | 233 Participants | 116 Participants |
| HIV Viral Suppression | 61 Participants | 94 Participants | 33 Participants |
| Placement in Permanent Housing | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Hispanic | 37 Participants | 78 Participants | 41 Participants |
| Race/Ethnicity, Customized Non-Hispanic Black | 70 Participants | 142 Participants | 72 Participants |
| Race/Ethnicity, Customized Non-Hispanic White | 10 Participants | 15 Participants | 5 Participants |
| Race/Ethnicity, Customized Unknown | 0 Participants | 1 Participants | 1 Participants |
| Region of Enrollment United States | 117 Participants | 236 Participants | 119 Participants |
| Sex/Gender, Customized Female | 21 Participants | 51 Participants | 30 Participants |
| Sex/Gender, Customized Male | 90 Participants | 174 Participants | 84 Participants |
| Sex/Gender, Customized Transgender | 6 Participants | 11 Participants | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 6 / 119 | 4 / 117 |
| other Total, other adverse events | 0 / 119 | 0 / 117 |
| serious Total, serious adverse events | 0 / 119 | 0 / 117 |
Outcome results
Primary
Number of Participants With Placement in Permanent Housing
supportive housing, rental assistance, other non-emergency housing, etc.
Time frame: 12 months post-enrollment
Population: persons who survived 12 months post-enrollment
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Enhanced Housing Placement Assistance | Number of Participants With Placement in Permanent Housing | 53 Participants |
| Standard Housing Placement Assistance | Number of Participants With Placement in Permanent Housing | 37 Participants |
Secondary
Number of Participants With Engagement in HIV Care
any reported HIV viral load (VL) or CD4 test
Time frame: 12 months post-enrollment
Population: persons who survived 12 months post-enrollment
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Enhanced Housing Placement Assistance | Number of Participants With Engagement in HIV Care | 109 Participants |
| Standard Housing Placement Assistance | Number of Participants With Engagement in HIV Care | 110 Participants |
Secondary
Number of Participants With HIV Viral Suppression
Last viral load is under 200 copies/mL
Time frame: 12 months post-enrollment
Population: persons who survived 12 months post-enrollment
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Enhanced Housing Placement Assistance | Number of Participants With HIV Viral Suppression | 53 Participants |
| Standard Housing Placement Assistance | Number of Participants With HIV Viral Suppression | 64 Participants |