The effect of homelessness on viral suppression in an underserved metropolitan area of middle Tennessee: potential implications for ending the HIV epidemic

• Published in: BMC infectious diseases Vol. 22; no. 1; pp. 144 - 7
• Main Authors: Berthaud, Vladimir, Johnson, Livette, Jennings, Ronda, Chandler-Auguste, Maxine, Osijo, Abosede, Baldwin, Marie T., Matthews-Juarez, Patricia, Juarez, Paul, Wilus, Derek, Tabatabai, Mohammad
• Format: Journal Article
• Language: English
• Published: London BioMed Central 10.02.2022; BioMed Central Ltd; BMC
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome; AIDS; And viral suppression; Care and treatment; Demographic aspects; Health aspects; Health insurance; HIV; HIV infection; HIV Infections - drug therapy; HIV Infections - epidemiology; Homeless people; Homeless Persons; Homelessness; Human immunodeficiency virus; Humans; Infectious Diseases; Internal Medicine; Marginalized groups; Medical Microbiology; Medicine; Medicine & Public Health; Metropolitan areas; Observational studies; Parasitology; Patients; Poverty; Prevention; Prophylaxis; Research Article; Social determinants; Tennessee - epidemiology; Tropical Medicine; Underserved populations; Urban areas; Tennessee; United States > US; Nashville Tennessee; Homelessness; HIV; And viral suppression; Social determinants
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-022-07105-y

Background A wealth of scientific evidence supports the effectiveness of HIV prophylaxis and treatment. Homelessness is strongly associated with the health status and viral suppression among underserved populations and can undermine the national plan to eliminate HIV by 2030. This retrospective observational study examined the extent in which homelessness affects HIV treatment in an underserved urban area of Middle Tennessee in 2014–2019. Results Among 692 HIV-seropositive patients, the proportion of homeless patients increased from 13.5% in 2014 to 27.7% in 2019, thrice the national average for HIV-seropositive people (8.4%) and twice that of HIV positive patients who are participating in Ryan White programs nationwide (12.9%). Our findings suggest that homeless patients were half as likely to achieve viral suppression as compared to those who had a permanent/stable home [OR 0.48 (0.32–0.72), p-value < 0.001]. Conclusion Our study indicates that homelessness may play an important role in viral suppression among persons living with HIV/AIDS in Middle Tennessee.