Date of Award

5-15-2020

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Ashli Owen-Smith

Second Advisor

Jasmine Rockwell

Abstract

INTRODUCTION: Previous studies have indicated an association between housing insecurity and the management of HIV. Specifically, several of these studies have documented an association between having temporary housing and low CD4 count, one marker for HIV viral load suppression. However, there is some variation in the literature that may suggest that housing status alone does not predict CD4 count. The objective of this study is to further examine this association between temporary housing status and low CD4 count.

METHODS: A cross-sectional study was conducted with clients (n=117) sampled from a Homeless Management Information System (HMIS). These clients were separated into two housing categories (temporary and permanent) and two CD4 count categories (below 200 cells/µL and above 200 cells/µL). Logistic regression was performed to obtain odds ratios from two models (crude and adjusted) to examine the association between housing status and CD4 count.

RESULTS: There was no statistically significant association between temporary housing status and CD4 count under 200 cells/µL in the crude model (OR=2.275, 95% CI: 0.628, 8.241). However, there was a statistically significant association between temporary housing status and CD4 count under 200 cells/µL in the adjusted model (OR=5.708, 95% CI: 1.087, 29.979).

DISCUSSION: The findings of the adjusted model were statistically significant. However, the confidence interval was very wide, and the lower bound was very close to the null. This was likely a result of limited statistical power from low sample size (n=117). Future research is needed to further explore this association and to assess the impact of possible mediating factors such as injection drug use, sexual activity, and incarceration history.

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