Influence of Jail Incarceration and Homelessness Patterns on Engagement in HIV Care and HIV Viral Suppression among New York City Adults Living with HIV/AIDS

• DOI: 10.1371/journal.pone.0141912
• Publication Date: 2015-11-24T16:14:05Z
• Authors: Sungwoo Lim; Denis Nash; Laura Hollod; Tiffany G. Harris; Mary Clare Lennon; Lorna E. Thorpe
• Keywords: Supportive housing

Both homelessness and incarceration are associated with housing instability, which in turn can disrupt continuity of HIV medical care. Yet, their impacts have not been systematically assessed among people living HIV/AIDS (PLWHA).We studied a retrospective cohort 1,698 New York City PLWHA both jail during 2001-05 to evaluate whether frequent transitions between were lower likelihood care subsequent one-year follow-up period. Using matched jail, single-adult homeless shelter, registry data, we performed sequence analysis identify trajectories these events influence on engagement viral suppression via marginal structural modeling.Sequence identified four trajectories; 72% the had sporadic experiences brief homelessness, whereas others experienced more consistent or early late months. Trajectories differential follow-up. However, compared experiencing bouts later minimal incarceration/homelessness events, observed prevalence two other trajectories: those sporadic, occurrences (0.67, 95% CI = 0.50,0.90) extensive (0.62, 0.43,0.88).Housing instability due may exert negative influences suppression. Policies services that support stability should be strengthened incarcerated sheltered reduce risk adverse health conditions.