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Abstract
Unstable housing, associated risk behaviour, and increased risk for HIV infection among injection drug users.
Corneil T.A.1, Kuyper L.M.2, Shoveller J.1, Hogg R.S.1, Li K.2, Spittal P.M.1, Schechter M.T.1, Wood E.2
Introduction: In an effort to find a predictive ´upstream´ determinant of HIV transmission in IDU´s, we examined the relationship between housing status and the risk of HIV-infection, including an analysis of HIV risk behaviours.
Methods: We evaluated cumulative rates of HIV infection within an IDU cohort stratified by their baseline housing status using the Kaplan–Meier method. HIV incidence rates were compared using the log-rank test. We modeled factors associated with the time to HIV infection using Cox’s regression. In a secondary analysis, we looked for factors potentially associated with residing in unstable housing using generalized estimating equations (GEE) for binary outcomes with logit link for the analysis of correlated data.
Results: Between May 1996 and May 2003, 1013 baseline HIV negative individuals were recruited and had at least one follow-up visit. At baseline, 406 (40%) individuals reported stable housing, and 607 (60%) individuals reported unstable housing. Of these, 125 individuals became HIV-infected yielding a cumulative incidence rate of 3.21/100 person-years. Analysis of time to HIV infection, demonstrated an elevated rate in those residing in unstable housing at baseline (log-rank p = 0.007). In unadjusted Cox analysis, association with unstable housing was found to be significant(RH: 1.59, 95% CI: 1.11–2.27). In the adjusted model, significant factors included Aboriginal ethnicity, daily cocaine injection, and borrowing syringes. Unstable housing was only marginally associated (adjusted RH: 1.38, 95% CI: 0.96–1.99, p-value = 0.084). However using bi-variate GEE analysis, unstable housing was significantly associated with being younger, female, using daily heroin, cocaine, or crack, borrowing syringes, non-MMT, sex-trade, lack of addiction treatment, and unprotected intercourse.
Conclusions: Describing the relationships between unstable housing, HIV, and associated risk behaviours has important implications for policy makers and program planners. We add quantitative support to ethnographic and social literature describing the importance of sustainable housing as a determinant of health in IDUs.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
WePe10.4P01
Suggested Citation
"CorneilT.A., et al.
Unstable housing, associated risk behaviour, and increased risk for HIV infection among injection drug users..
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
WePe10.4P01"
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