Offering a comprehensive set of key services to people experiencing housing challenges can often help those who are living with HIV achieve viral suppression, a study published in AIDS showed.
POP-UP, which is run out of San Francisco’s Ward 86 HIV clinic, offers housing assistance, HIV and primary care, patient navigation, and financial incentives to PLWH who are experiencing homelessness or unstable housing. Between January 2019 and February 2020, 192 PLWH were referred to the program, 152 were eligible for the study, and 75 were enrolled in the study. (Of the remaining 77, 67 were lost to follow-up, showing one of the challenges of working with this population.)
No study participant was on antiretrovirals at enrollment, but all were treatment experienced. All had a substance use disorder (mostly methamphetamine) and 77% had also been diagnosed with a mental health issue. Sixteen people were disenrolled, including three suspensions for violent behavior and one prison stay.
Among enrolled participants, the cumulative incidence of re-starting antiretroviral treatment within seven days was 79%, and 55% were virally suppressed after six months of follow-up. (No control group was included because withholding services was considered unethical.)
Study authors called for additional research into the cost and potential for expansion of similar programs. “Affordable housing is ultimately needed to achieve the goals of the Ending the HIV Epidemic Initiative,” they concluded, but tailored services could fill the treatment gap in the meantime.