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Consequences of homelessness - such
as not having access to sleeping quarters, regular meals, clean clothing and
hygiene essentials - had the greatest single effect on the physical and mental
health of homeless HIV patients, according to a University of California-San
Francisco (UCSF) survey.
The study’s 288 homeless male
participants were given physical and mental health scores between zero and 100.
The median physical and mental health scores were 43 and 46, respectively.
Unmet basic needs most greatly affected scores, lowering the physical health
score 3.8 percent, and the mental score by 3.5 percent. Although regular use of
antiretrovirals raised mental health scores 1.7 percent, the drugs only
negligibly affected physical health scores.
Elise Riley, the study’s lead author
and an associate professor in the UCSF HIV/AIDS division at San Francisco
General Hospital (SFGH), said keeping patients healthy and halting the spread
of the virus requires a simultaneous focus on subsistence needs and HIV
treatments. Spending on medication is “not going to be doing as much good if we
don’t have more opportunities for housing or other needs,” said Riley.
SFGH HIV Clinic Medical Director Dr.
Brad Hare agrees. He said the recession exacerbates the struggle to regulate
treatment for patients who must prioritize basic necessities. “This study
validates what we’ve seen,” said Hare. “It recognizes just how important the
structural barriers are to HIV care.”
Dr. Edward Machtinger, UCSF’s
Women’s HIV program director, found comparable associations between trauma and
poor health outcomes for HIV-positive women in other studies. Machtinger said
health providers must “ask the real questions” about patients’ needs and
prioritize linking them to existing services.
“Our focus in medicine needs to be
broader than simply seeing patients in clinic and prescribing medications,”
Machtinger said.
The study, “Social, Structural and
Behavioral Determinants of Overall Health Status in a Cohort of Homeless and
Unstably Housed HIV-Infected Men,” was published in PLoS One (2012;7(4):e35207).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
TOGETHER WE REMAIN STRONG!
