Facilitated Stable Housing as a Strategy for Uptake and Sustainment of Evidence-Based HIV and Cardiometabolic Medicine in People with HIV
Donny Gerke, Ph.D.
University of Alabama at Birmingham
People living with HIV (PWH) have a much higher risk of cardiometabolic disease than people without HIV. We know that early and effective medical treatment of HIV can reduce risk for HIV-associated cardiometabolic disease, so helping PWH enter and remain in treatment is key. We also have effective medical treatments for cardiometabolic disease. However, PWH who do not have stable housing are less likely to get consistent medical care and therefore have poorer HIV and cardiometabolic disease outcomes. The UAB 1917 Clinic and AIDS Alabama have partnered since 2017 to address this by facilitating stable housing for PWH through AIDS Alabama’s federally funded Housing Opportunities for People with HIV/AIDS (HOPWA) program. However, we have not yet fully evaluated if getting and maintaining housing through that program leads to better HIV and cardiometabolic outcomes for PWH in the Birmingham area. Assuming that the housing program does help some PWH improve their health outcomes, this study will provide data that will help administrators advocate for continued or increased funding to support this vital resource. In addition, understanding what parts of the program are most and least helpful will lead to an improved housing program, which should result in improved health for more PWH and ultimately reduced HIV and cardiometabolic-related disability/death in the region.
The primary goals of this project are: 1) Determine if helping people with HIV (PWH) to access stable housing is associated with better HIV and cardiometabolic outcomes over a 2-year period; 2) Understand PWH’s experience of the housing program, including what aspects of the program they believe were most and least helpful in supporting their engagement with medical care for HIV and cardiometabolic disease; 3) Gain insight from social workers/case managers involved in the housing program process to more fully understand the different components of the housing program and to determine which parts are working well and which may need to be changed or improved; and 4) Measure the cost of the housing program and determine feasibility of growing the program. This project will advance HIV-specific scholarship focused on improving medical outcomes by addressing a key social determinant of health: housing. It will also identify mechanisms, or parts of the facilitated stable housing process, that are most important in helping PWH enter and remain in medical care and experience better HIV and cardiometabolic outcomes.
