Social, structural and behavioral determinants of overall health status in a cohort of homeless and unstably housed HIV-infected men.

PloS One
Elise D RileyDiane Havlir

Abstract

Previous studies indicate multiple influences on the overall health of HIV-infected persons; however, few assess and rank longitudinal changes in social and structural barriers that are disproportionately found in impoverished populations. We empirically ranked factors that longitudinally impact the overall health status of HIV-infected homeless and unstably housed men. Between 2002 and 2008, a cohort of 288 HIV+ homeless and unstably housed men was recruited and followed over time. The population was 60% non-Caucasian and the median age was 41 years; 67% of study participants reported recent drug use and 20% reported recent homelessness. At baseline, the median CD4 cell count was 349 cells/µl and 18% of eligible persons (CD4<350) took antiretroviral therapy (ART). Marginal structural models were used to estimate the population-level effects of behavioral, social, and structural factors on overall physical and mental health status (measured by the SF-36), and targeted variable importance (tVIM) was used to empirically rank factors by their influence. After adjusting for confounding, and in order of their influence, the three factors with the strongest negative effects on physical health were unmet subsistence needs, Caucasian r...Continue Reading

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Citations

Sep 13, 2014·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Kelly M DoranElise D Riley
Nov 10, 2013·PloS One·Judith Tedlie MoskowitzMichael Acree
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Jun 8, 2015·Current Opinion in HIV and AIDS·Diane Havlir, Monica Gandhi
Mar 31, 2020·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Antoinette L SpectorJulia Dickson-Gomez
Jan 31, 2021·Journal of General Internal Medicine·Andrea WangStephen W Hwang
Apr 27, 2021·Journal of Community Psychology·Martha P MontgomeryEmily Mosites

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