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Chicago Housing for Health Partnership: HIV Outcomes

Chicago Housing for Health Partnership: HIV Outcomes. David Buchanan MD MS, Romina Kee MD MPH, Laura Sadowski MD MPH, Diana Garcia MPH North American Housing & HIV/AIDS Research Summit June 4, 2009. What is the root cause of poor health among homeless patients?.

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Chicago Housing for Health Partnership: HIV Outcomes

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  1. Chicago Housing for Health Partnership: HIV Outcomes David Buchanan MD MS, Romina Kee MD MPH, Laura Sadowski MD MPH, Diana Garcia MPH North American Housing & HIV/AIDS Research Summit June 4, 2009

  2. What is the root cause of poor health among homeless patients? • Does homelessness lead to poor health? • Providing housing would improve health • Do other social factors lead to both poor health and homelessness? • Providing housing would not help much

  3. Health Outcomes: Why HIV? • Top qualifying medical illness • Effective treatments for HIV exist • Housing stability may impact the effectiveness of HIV treatment • Markers for HIV Disease progression

  4. HIV Outcomes: Hypothesis Providing permanent housing and intensive case management to hospitalized HIV+ homeless patients will improve their survival with an intact immune system one year later

  5. HIV Outcomes: Methods • Inclusion: Enrolled at Stroger Hospital, HIV+ • 1 year later - CD4 count & Viral load • 1º Endpoint – Survival with intact immunity • Alive with CD4 > 200 and Viral Load < 100K • 2º Endpoints • CD4 Counts • HIV viral loads • Undetectable viral loads

  6. HIV Outcomes – Data Sources • 105 Eligible (HIV+ Stroger Hosp enrollees) • 66 Visited Reference Lab or Died - 63% • 28 Labs - Outpatient usual care - 27% • 11 No labs & not deceased - 10%

  7. Survival with intact immunity P = 0.04

  8. CD4 (T Cell) Counts P = 0.23 Patients CD4 Counts - higher is better

  9. HIV Viral Loads P = 0.03 for trend Patients Viral Loads - lower number is better

  10. Viral Load (Mean) P = 0.03 MeanViral Load

  11. CHHP HIV Outcomes Summary

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