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Improving Care Outcomes for PLWH Experiencing Homelessness and Unstable Housing: a Synthetic Review of Clinic-Based Strategies

  • Implementation Science (E Geng, Section Editor)
  • Published:
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Abstract

Purpose of Review

Singular interventions targeting vulnerable populations of people living with HIV (PLWH) are necessary for reducing new infections and optimizing individual-level outcomes, but extant literature for PLWH who experience homelessness and unstable housing (HUH) has not been compiled. To inform implementation of clinic-based programs that improve care outcomes in this population, we present a synthetic review of key studies examining clinic-based interventions, specifically case management, patient navigation, financial incentives, and the use of mobile technology.

Recent Findings

Results from unimodal interventions are mixed or descriptive, are limited by inability to address related multi-modal barriers to care, and do not address major challenges to implementation.

Summary

Multi-component interventions are needed, but gaps in our knowledge base may limit widespread uptake of such interventions before further data are compiled. Future research evaluating interventions for PLWH experiencing HUH should include implementation outcomes in order to facilitate adaptation across diverse clinical settings.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV Epidemic: a plan for the United States. JAMA. 2019;321(9):844–5. https://doi.org/10.1001/jama.2019.1343.

    Article  PubMed  Google Scholar 

  2. Riley ED, Gandhi M, Hare C, Cohen J, Hwang S. Poverty, unstable housing, and HIV infection among women living in the United States. Curr HIV/AIDS Rep. 2007;4(4):181–6.

    Article  Google Scholar 

  3. Flentje A, Shumway M, Wong LH, Riley ED. Psychiatric risk in unstably housed sexual minority women: relationship between sexual and racial minority status and human immunodeficiency virus and psychiatric diagnoses. Womens Health Issues. 2017;27(3):294–301. https://doi.org/10.1016/j.whi.2016.12.005.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Riley ED, Moore K, Sorensen JL, Tulsky JP, Bangsberg DR, Neilands TB. Basic subsistence needs and overall health among human immunodeficiency virus-infected homeless and unstably housed women. Am J Epidemiol. 2011;174(5):515–22. https://doi.org/10.1093/aje/kwr209.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tsai AC, Weiser SD, Dilworth SE, Shumway M, Riley ED. Violent victimization, mental health, and service utilization outcomes in a cohort of homeless and unstably housed women living with or at risk of becoming infected with HIV. Am J Epidemiol. 2015;181(10):817–26. https://doi.org/10.1093/aje/kwu350.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Tsai AC, Mendenhall E, Trostle JA, Kawachi I. Co-occurring epidemics, syndemics, and population health. Lancet. 2017;389(10072):978–82. https://doi.org/10.1016/S0140-6736(17)30403-8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Carrico AW, Hunt PW, Neilands TB, Dilworth SE, Martin JN, Deeks SG, et al. Stimulant use and viral suppression in the era of universal antiretroviral therapy. J Acquir Immune Defic Syndr. 2019;80(1):89–93. https://doi.org/10.1097/QAI.0000000000001867.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Holtzman CW, Shea JA, Glanz K, Jacobs LM, Gross R, Hines J, et al. Mapping patient-identified barriers and facilitators to retention in HIV care and antiretroviral therapy adherence to Andersen’s Behavioral Model. AIDS Care. 2015;27(7):817–28. https://doi.org/10.1080/09540121.2015.1009362.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Yehia BR, Stewart L, Momplaisir F, et al. Barriers and facilitators to patient retention in HIV care. BMC Infect Dis. 2015;15. https://doi.org/10.1186/s12879-015-0990-0.

  10. Dombrowski JC, Simoni JM, Katz DA, Golden MR. Barriers to HIV care and treatment among participants in a public health HIV care relinkage program. AIDS Patient Care STDs. 2015;29(5):279–87. https://doi.org/10.1089/apc.2014.0346.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Clemenzi-Allen A, Neuhaus J, Geng E, et al. Housing instability results in increased acute care utilization in an urban HIV clinic cohort. Open Forum Infect Dis. 2019;6(5). https://doi.org/10.1093/ofid/ofz148.

  12. Cunningham WE, Sohler NL, Tobias C, Drainoni ML, Bradford J, Davis C, et al. Health services utilization for people with HIV infection: comparison of a population targeted for outreach with the U.S. population in care. Med Care. 2006;44(11):1038–47. https://doi.org/10.1097/01.mlr.0000242942.17968.69.

    Article  PubMed  Google Scholar 

  13. Aidala AA, Lee G, Abramson DM, Messeri P, Siegler A. Housing need, housing assistance, and connection to HIV medical care. AIDS Behav. 2007;11(S2):101–15. https://doi.org/10.1007/s10461-007-9276-x.

    Article  PubMed  Google Scholar 

  14. Doshi RK, Milberg J, Jumento T, Matthews T, Dempsey A, Cheever LW. For many served by the Ryan White HIV/AIDS program, disparities in viral suppression decreased, 2010-14. Health Aff (Millwood). 2017;36(1):116–23. https://doi.org/10.1377/hlthaff.2016.0655.

    Article  Google Scholar 

  15. Mandsager P, Marier A, Cohen S, Fanning M, Hauck H, Cheever LW. Reducing HIV-related health disparities in the Health Resources and Services Administration’s Ryan White HIV/AIDS Program. Am J Public Health. 2018;108(S4):S246–50. https://doi.org/10.2105/AJPH.2018.304689.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Clemenzi-Allen A, Geng E, Christopoulos K, et al. Degree of housing instability shows independent “dose-response” with virologic suppression rates among people living with human immunodeficiency virus. Open Forum Infect Dis. 2018;5(3). https://doi.org/10.1093/ofid/ofy035.

  17. Centers for Disease Control and Prevention (CDC). Vital signs: HIV prevention through care and treatment--United States. MMWR Morb Mortal Wkly Rep. 2011;60(47):1618–23.

    Google Scholar 

  18. Spinelli M, Hessol N, Schwarcz S, Hsu L, Parisi MK, Pipkin S, et al. Homelessness at diagnosis is associated with death among people with HIV in a population-based study of a US city. Aids. 2019;33(11):1789–94. https://doi.org/10.1097/QAD.0000000000002287.

    Article  PubMed  Google Scholar 

  19. Hall G, Singh T, Lim SW. Supportive housing promotes AIDS-free survival for chronically homeless HIV positive persons with behavioral health conditions. AIDS Behav. 2019;23(3):776–83. https://doi.org/10.1007/s10461-019-02398-8.

    Article  PubMed  Google Scholar 

  20. Kertesz SG, Baggett TP, O’Connell JJ, Buck DS, Kushel MB. Permanent supportive housing for homeless people — reframing the debate. N Engl J Med. 2016. https://doi.org/10.1056/NEJMp1608326.

    Article  Google Scholar 

  21. Kushel M, Hepatitis A. Outbreak in California — addressing the root cause. N Engl J Med. 2018;378(3):211–3. https://doi.org/10.1056/NEJMp1714134.

    Article  PubMed  Google Scholar 

  22. Operario D, Nemoto T. HIV in transgender communities: syndemic dynamics and a need for multicomponent interventions. J Acquir Immune Defic Syndr. 2010;55(Suppl 2):S91–3. https://doi.org/10.1097/QAI.0b013e3181fbc9ec.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Metsch LR, Pugh T, Colfax G. An HIV behavioral intervention gets it right—and shows we must do even better. JAMA Intern Med. 2018;178(4):553–5. https://doi.org/10.1001/jamainternmed.2018.0096.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hwang SW, Burns T. Health interventions for people who are homeless. Lancet. 2014;384(9953):1541–7. https://doi.org/10.1016/S0140-6736(14)61133-8.

    Article  PubMed  Google Scholar 

  25. Liau A, Crepaz N, Lyles CM, Higa DH, Mullins MM, DeLuca J, et al. Interventions to promote linkage to and utilization of HIV medical care among HIV-diagnosed persons: a qualitative systematic review, 1996–2011. AIDS Behav. 2013;17(6):1941–62. https://doi.org/10.1007/s10461-013-0435-y.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Higa DH, Marks G, Crepaz N, Liau A, Lyles CM. Interventions to improve retention in HIV primary care: a systematic review of U.S. studies. Curr HIV/AIDS Rep. 2012;9(4):313–25. https://doi.org/10.1007/s11904-012-0136-6.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Weiser SD, Hatcher A, Frongillo EA, Guzman D, Riley ED, Bangsberg DR, et al. Food insecurity is associated with greater acute care utilization among HIV-infected homeless and marginally housed individuals in San Francisco. J Gen Intern Med. 2013;28(1):91–8. https://doi.org/10.1007/s11606-012-2176-4.

    Article  PubMed  Google Scholar 

  28. Katz I, Jha AK. HIV in the United States: getting to zero transmissions by 2030. JAMA. 2019;321(12):1153–4. https://doi.org/10.1001/jama.2019.1817.

    Article  PubMed  Google Scholar 

  29. Grimsrud A, Bygrave H, Doherty M, Ehrenkranz P, Ellman T, Ferris R, et al. Reimagining HIV service delivery: the role of differentiated care from prevention to suppression. J Int AIDS Soc. 2016;19(1):21484. https://doi.org/10.7448/IAS.19.1.21484.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Buchanan D, Kee R, Sadowski LS, Garcia D. The health impact of supportive housing for HIV-positive homeless patients: a randomized controlled trial. Am J Public Health. 2009;99(Suppl 3):S675–80. https://doi.org/10.2105/AJPH.2008.137810.

    Article  PubMed  PubMed Central  Google Scholar 

  31. • Towe VL, Wiewel EW, Zhong Y, Linnemayr S, Johnson R, Rojas J. A Randomized controlled trial of a rapid re-housing intervention for homeless persons living with HIV/AIDS: impact on housing and HIV medical outcomes. AIDS Behav. 2019. https://doi.org/10.1007/s10461-019-02461-4While this study has major limitations in.

    Article  Google Scholar 

  32. •• Cunningham WE, Weiss RE, Nakazono T, et al. Effectiveness of a peer navigation intervention to sustain viral suppression among HIV-positive men and transgender women released from jail: the LINK LA randomized clinical trial. JAMA Intern Med. 2018;178(4):542–53. https://doi.org/10.1001/jamainternmed.2018.0150This study is a large, well-designed randomized control trial of a peer navigation program for vulnerable populations leaving jail. While the study is not powered to detect subgroup heterogeneity, the differential impact of this peer navigation program among homeless and unstably housed PLWH is demonstrated, suggesting that among this vulnerable population, peer navigation could be a foundation model component to program success.

    Article  PubMed  PubMed Central  Google Scholar 

  33. • Metsch LR, Feaster DJ, Gooden L, et al. Effect of patient navigation with or without financial incentives on viral suppression among hospitalized patients with hiv infection and substance use: a randomized clinical trial. JAMA. 2016;316(2):156–70. https://doi.org/10.1001/jama.2016.8914This is a large, well-designed, three-armed randomized control trial of financial incentives plus patient navigation versus patient navigation alone versus treatment as usual (e.g. discharge planning) for PLWH who inject drugs that are being discharged from the hospital. This study highlights the limited efficacy and durability of financial incentives on virologic suppression and appointment attendance for a population with high levels of unmet needs.

    Article  PubMed  PubMed Central  Google Scholar 

  34. • Christopoulos KA, Riley ED, Carrico AW, et al. A randomized controlled trial of a text messaging intervention to promote virologic suppression and retention in care in an urban safety-net HIV clinic: the Connect4Care (C4C) trial. Clin Infect Dis. 2018. https://doi.org/10.1093/cid/ciy156This is a large, well-designed randomized control trial evaluating the use of cellphones for adherence support, appointment reminders and positive emotional support that did not demonstrate efficacy. The results suggest that among vulnerable populations, with high rates of unmet needs and high rates of property loss, text messaging interventions may be significantly limited at improving care cascade outcomes.

    Article  Google Scholar 

  35. Recommendations for Case Management Collaboration and Coordination in Federally Funded HIV/ AIDS Programs. :50.

  36. Thompson MA, Mugavero MJ, Amico KR, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Ann Intern Med. 2012;156(11):817–33, W-284, W-285, W-286, W-287, W-288, W-289, W-290, W-291, W-292, W-293, W-294. https://doi.org/10.7326/0003-4819-156-11-201206050-00419.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kushel MB, Colfax G, Ragland K, Heineman A, Palacio H, Bangsberg DR. Case management is associated with improved antiretroviral adherence and CD4 + cell counts in homeless and marginally housed individuals with HIV infection. Clin Infect Dis. 2006;43(2):234–42. https://doi.org/10.1086/505212.

    Article  CAS  PubMed  Google Scholar 

  38. Katz MH, Cunningham WE, Fleishman JA, Andersen RM, Kellogg T, Bozzette SA, et al. Effect of case management on unmet needs and utilization of medical care and medications among HIV-infected persons. Ann Intern Med. 2001;135(8 Pt 1):557–65.

    Article  CAS  Google Scholar 

  39. Rajabiun S, Tryon J, Feaster M, et al. The influence of housing status on the HIV continuum of care: results from a multisite study of patient navigation models to build a medical home for people living with HIV experiencing homelessness. Am J Public Health. 2018;108(Suppl 7):S539–45. https://doi.org/10.2105/AJPH.2018.304736.

    Article  PubMed Central  Google Scholar 

  40. Irvine MK, Chamberlin SA, Robbins RS, Kulkarni SG, Robertson MM, Nash D. Come as you are: improving care engagement and viral load suppression among HIV care coordination clients with lower mental health functioning, unstable housing, and hard drug use. AIDS Behav. 2017;21(6):1572–9. https://doi.org/10.1007/s10461-016-1460-4.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Gardner LI, Metsch LR, Anderson-Mahoney P, et al. Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care. AIDS. 2005;19(4):423–31.

    Article  Google Scholar 

  42. •• Gardner LI, Marks G, Craw J, et al. Demographic, psychological, and behavioral modifiers of the Antiretroviral Treatment Access Study (ARTAS) intervention. AIDS Patient Care STDs. 2009;23(9):735–42. https://doi.org/10.1089/apc.2008.0262This study is a secondary analysis of a foundational, well-designed randomized control trial for that demonstrates a substantial and significant differential impact of a brief strengths-based case management intervention for people newly diagnosed with HIV that are experiencing homelessness and unstable housing.

    Article  PubMed  Google Scholar 

  43. Spaulding AC, Drobeniuc A, Frew PM, et al. Jail, an unappreciated medical home: assessing the feasibility of a strengths-based case management intervention to improve the care retention of HIV-infected persons once released from jail. PLoS One. 2018;13(3). https://doi.org/10.1371/journal.pone.0191643.

    Article  Google Scholar 

  44. Johnson MO, Chesney MA, Goldstein RB, Remien RH, Catz S, Gore-Felton C, et al. Positive provider interactions, adherence self-efficacy, and adherence to antiretroviral medications among HIV-infected adults: a mediation model. AIDS Patient Care STDs. 2006;20(4):258–68. https://doi.org/10.1089/apc.2006.20.258.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Broaddus MR, Owczarzak J, Schumann C, Koester KA. Fostering a “feeling of worth” among vulnerable HIV populations: the role of linkage to care specialists. AIDS Patient Care STDs. 2017;31(10):438–46. https://doi.org/10.1089/apc.2017.0048.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Taylor BS, Fornos L, Tarbutton J, Muñoz J, Saber JA, Bullock D, et al. Improving HIV care engagement in the south from the patient and provider perspective: the role of stigma, social support, and shared decision-making. AIDS Patient Care STDs. 2018;32(9):368–78. https://doi.org/10.1089/apc.2018.0039.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Mizuno Y, Higa DH, Leighton CA, Roland KB, Deluca JB, Koenig LJ. Is HIV patient navigation associated with HIV care continuum outcomes? AIDS. 2018;32(17):2557–71. https://doi.org/10.1097/QAD.0000000000001987.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Cabral HJ, Davis-Plourde K, Sarango M, Fox J, Palmisano J, Rajabiun S. Peer support and the HIV continuum of care: results from a multi-site randomized clinical trial in three urban clinics in the United States. AIDS Behav. 2018;22(8):2627–39. https://doi.org/10.1007/s10461-017-1999-8.

    Article  PubMed  Google Scholar 

  49. Myers JJ, Kang Dufour M-S, Koester KA, Morewitz M, Packard R, Monico Klein K, et al. The effect of patient navigation on the likelihood of engagement in clinical care for HIV-infected individuals leaving jail. Am J Public Health. 2018;108(3):385–92. https://doi.org/10.2105/AJPH.2017.304250.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Rajabiun S, Cabral H, Tobias C, Relf M. Program design and evaluation strategies for the special projects of national significance outreach initiative. AIDS Patient Care STDs. 2007;21(s1):S-9–S-19. https://doi.org/10.1089/apc.2007.9991.

    Article  Google Scholar 

  51. McInnes DK, Li AE, Hogan TP. Opportunities for engaging low-income, vulnerable populations in health care: a systematic review of homeless persons’ access to and use of information technologies. Am J Public Health. 2013;103(S2):e11–24. https://doi.org/10.2105/AJPH.2013.301623.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Catalani C, Philbrick W, Fraser H, Patricia M, Israelski DM. mHealth for HIV treatment & prevention: a systematic review of the literature. Open AIDS J. 2013;7:17–41. https://doi.org/10.2174/1874613620130812003.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Garofalo R, Kuhns LM, Hotton A, Johnson A, Muldoon A, Rice D. A randomized controlled trial of personalized text message reminders to promote medication adherence among HIV-positive adolescents and young adults. AIDS Behav. 2016;20(5):1049–59. https://doi.org/10.1007/s10461-015-1192-x.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Ingersoll KS, Dillingham RA, Hettema JE, Conaway M, Freeman J, Reynolds G, et al. Pilot RCT of bidirectional text messaging for ART adherence among nonurban substance users with HIV. Health Psychol. 2015;34S:1305–15. https://doi.org/10.1037/hea0000295.

    Article  PubMed  Google Scholar 

  55. Kuo I, Liu T, Patrick R, Trezza C, Bazerman L, Uhrig Castonguay BJ, et al. Use of an mHealth intervention to improve engagement in HIV community-based care among persons recently released from a correctional facility in Washington, DC: A Pilot Study. AIDS Behav. 2019;23(4):1016–31. https://doi.org/10.1007/s10461-018-02389-1.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Wohl DA, Golin CE, Knight K, et al. Randomized controlled trial of an intervention to maintain suppression of HIV viremia after prison release: the imPACT trial. J Acquir Immune Defic Syndr. 2017;75(1):81–90. https://doi.org/10.1097/QAI.0000000000001337.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Dillingham R, Ingersoll K, Flickinger TE, Waldman AL, Grabowski M, Laurence C, et al. PositiveLinks: a mobile health intervention for retention in HIV care and clinical outcomes with 12-month follow-up. AIDS Patient Care STDs. 2018;32(6):241–50. https://doi.org/10.1089/apc.2017.0303.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Canan CE, Waselewski ME, Waldman ALD, et al. Long term impact of PositiveLinks: clinic-deployed mobile technology to improve engagement with HIV care. PLoS One. 2020;15(1). https://doi.org/10.1371/journal.pone.0226870.

    Article  CAS  Google Scholar 

  59. Cooper V, Clatworthy J, Whetham J, Consortium E. mHealth interventions to support self-management in HIV: a systematic review. Open AIDS J. 2017;11:119–32. https://doi.org/10.2174/1874613601711010119.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Rana AI, van den Berg JJ, Lamy E, Beckwith CG. Using a mobile health intervention to support HIV treatment adherence and retention among patients at risk for disengaging with care. AIDS Patient Care STDs. 2016;30(4):178–84. https://doi.org/10.1089/apc.2016.0025.

    Article  PubMed  PubMed Central  Google Scholar 

  61. • Stitzer M, Matheson T, Cunningham C, et al. Enhancing patient navigation to improve intervention session attendance and viral load suppression of persons with HIV and substance use: a secondary post hoc analysis of the Project HOPE study. Addict Sci Clin Pract. 2017;12(1):16. https://doi.org/10.1186/s13722-017-0081-1This secondary analysis of the Project HOPE study by Metsch et al 2016, while not powered for this outcome, this secondary analysis suggests that the use of financial incentives improves connection to navigation sessions despite that the original study did not demonstrate important care cascade outcomes.

    Article  PubMed  PubMed Central  Google Scholar 

  62. El-Sadr WM, Donnell D, Beauchamp G, et al. Financial incentives for linkage to care and viral suppression among HIV-positive patients: a randomized clinical trial (HPTN 065). JAMA Intern Med. 2017;177(8):1083–92. https://doi.org/10.1001/jamainternmed.2017.2158.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Sorensen JL, Haug NA, Delucchi KL, Gruber V, Kletter E, Batki SL, et al. Voucher reinforcement improves medication adherence in HIV-positive methadone patients: a randomized trial. Drug Alcohol Depend. 2007;88(1):54–63. https://doi.org/10.1016/j.drugalcdep.2006.09.019.

    Article  PubMed  Google Scholar 

  64. Galárraga O, Genberg BL, Martin RA, Barton Laws M, Wilson IB. Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations. AIDS Behav. 2013;17(7):2283–92. https://doi.org/10.1007/s10461-013-0415-2.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Rosen MI, Dieckhaus K, McMahon TJ, Valdes B, Petry NM, Cramer J, et al. Improved adherence with contingency management. AIDS Patient Care STDs. 2007;21(1):30–40. https://doi.org/10.1089/apc.2006.0028.

    Article  PubMed  Google Scholar 

  66. Wood TJ, Koester KA, Christopoulos KA, Sauceda JA, Neilands TB, Johnson MO. If someone cares about you, you are more apt to come around: improving HIV care engagement by strengthening the patient-provider relationship. Patient Prefer Adherence. 2018;12:919–27. https://doi.org/10.2147/PPA.S157003.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Beach MC, Keruly J, Moore RD. Is the quality of the patient-provider relationship associated with better adherence and health outcomes for patients with HIV? J Gen Intern Med. 2006;21(6):661–5. https://doi.org/10.1111/j.1525-1497.2006.00399.x.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Saha S, Korthuis PT, Cohn JA, Sharp VL, Moore RD, Beach MC. Primary care provider cultural competence and racial disparities in HIV care and outcomes. J Gen Intern Med. 2013;28(5):622–9. https://doi.org/10.1007/s11606-012-2298-8.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Dang BN, Westbrook RA, Hartman CM, Giordano TP. Retaining HIV patients in care: the role of initial patient care experiences. AIDS Behav. 2016;20(10):2477–87. https://doi.org/10.1007/s10461-016-1340-y.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Audain G, Bookhardt-Murray L, Fogg C. Adapting your practice: treatment and recommendations for unstably housed patients with HIV/AIDS. 2013. https://www.nhchc.org/wp-content/uploads/2011/09/AIDS.pdf. Accessed June 25, 2018.

  71. Dombrowski JC, Ramchandani M, Dhanireddy S, Harrington RD, Moore A, Golden MR. The max clinic: medical care designed to engage the hardest-to-reach persons living with HIV in Seattle and King County, Washington. AIDS Patient Care STDs. 2018;32(4):149–56. https://doi.org/10.1089/apc.2017.0313.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Dombrowski JC, Galagan SR, Ramchandani M, et al. HIV care for patients with complex needs: a controlled evaluation of a walk-in, incentivized care model. Open Forum Infect Dis. 2019;6(7). https://doi.org/10.1093/ofid/ofz294.

  73. Borne D, Tryon J, Rajabiun S, Fox J, de Groot A, Gunhouse-Vigil K. Mobile multidisciplinary HIV medical care for hard-to-reach individuals experiencing homelessness in San Francisco. Am J Public Health. 2018;108(S7):S528–30. https://doi.org/10.2105/AJPH.2018.304732.

    Article  PubMed Central  Google Scholar 

  74. O’Toole TP, Johnson EE, Borgia M, et al. Population-tailored care for homeless veterans and acute care use, cost, and satisfaction: a prospective quasi-experimental trial. Prev Chronic Dis. 2018;15. https://doi.org/10.5888/pcd15.170311.

  75. Kertesz SG, Holt CL, Steward JL, Jones RN, Roth DL, Stringfellow E, et al. Comparing homeless persons’ care experiences in tailored versus nontailored primary care programs. Am J Public Health. 2013;103(S2):S331–9. https://doi.org/10.2105/AJPH.2013.301481.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Volpp KG, Pauly MV, Loewenstein G, Bangsberg D. P4P4P: an agenda for research on pay for performance for patients. Health Aff (Millwood). 2009;28(1):206–14. https://doi.org/10.1377/hlthaff.28.1.206.

    Article  Google Scholar 

  77. Eisinger RW, Dieffenbach CW, Fauci AS. Role of implementation science: linking fundamental discovery science and innovation science to ending the HIV epidemic at the community level. J Acquir Immune Defic Syndr. 2019;82:S171. https://doi.org/10.1097/QAI.0000000000002227.

    Article  PubMed  Google Scholar 

  78. Dombrowski JC, Irvine M, Nash D, Harriman G, Golden MR. Public health practice-driven research to improve HIV prevention in the United States. J Acquir Immune Defic Syndr. 2019;82:S279. https://doi.org/10.1097/QAI.0000000000002194.

    Article  PubMed  Google Scholar 

  79. Buchbinder SP, Havlir DV. Getting to zero San Francisco: a collective impact approach. JAIDS J Acquir Immune Defic Syndr. 2019;82:S176. https://doi.org/10.1097/QAI.0000000000002200.

    Article  PubMed  Google Scholar 

  80. Schwartz SR, Rao A, Rucinski KB, et al. HIV-related implementation research for key populations: designing for individuals, evaluating across populations, and integrating context. J Acquir Immune Defic Syndr. 2019;82:S206. https://doi.org/10.1097/QAI.0000000000002191.

    Article  PubMed  Google Scholar 

  81. Mehrotra ML, Petersen ML, Geng EH. Understanding HIV program effects: a structural approach to context using the transportability framework. J Acquir Immune Defic Syndr. 2019;82:S199. https://doi.org/10.1097/QAI.0000000000002202.

    Article  PubMed  Google Scholar 

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Funding

A. Asa Clemenzi-Allen received support from T32AI060530-12. Elvin Geng was supported by K24 AI134413.

Author information

Authors and Affiliations

  1. Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA

    A. Asa Clemenzi-Allen, Matt Hickey, Elise Riley, Diane Havlir, Monica Gandhi & Elizabeth Imbert

  2. San Francisco Department of Public Health, San Francisco, CA, USA

    A. Asa Clemenzi-Allen

  3. Zucker School of Medicine at Hofstra, East Garden City, NY, USA

    Madellena Conte

  4. University of California, Berkeley, CA, USA

    Doyel Das

  5. Division of Infectious Diseases, School of Medicine, Washington University, St. Louis, MO, USA

    Elvin Geng

Authors
  1. A. Asa Clemenzi-Allen
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  2. Matt Hickey
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  3. Madellena Conte
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  4. Doyel Das
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  5. Elvin Geng
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  6. Elise Riley
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  7. Diane Havlir
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  8. Monica Gandhi
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  9. Elizabeth Imbert
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Corresponding author

Correspondence to A. Asa Clemenzi-Allen.

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Clemenzi-Allen, A.A., Hickey, M., Conte, M. et al. Improving Care Outcomes for PLWH Experiencing Homelessness and Unstable Housing: a Synthetic Review of Clinic-Based Strategies. Curr HIV/AIDS Rep 17, 259–267 (2020). https://doi.org/10.1007/s11904-020-00488-0

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