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A Randomized Controlled Trial of a Rapid Re-housing Intervention for Homeless Persons Living with HIV/AIDS: Impact on Housing and HIV Medical Outcomes

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We conducted a randomized controlled trial to determine whether, for homeless persons living with HIV/AIDS (PLWHA), rapid re-housing can improve housing and HIV viral suppression more than standard housing assistance. We recruited 236 PLWHA from HIV emergency housing in New York City (NYC) and randomized them to: (1) Enhanced Housing Placement Assistance (EHPA), i.e., immediate assignment to a case manager to rapidly re-house the client and provide 12 months of case management or (2) usual services, i.e., referral to an NYC housing placement program for which all HIV emergency housing residents were eligible. We compared time to stable housing placement and percentage virally suppressed from baseline to 12 months. EHPA clients were placed faster than usual services clients (p = 0.02; 25% placed by 150 days vs. 243 days, respectively), more likely to be placed [adjusted hazards ratio = 1.8; 95% confidence interval(CI) 1.1–2.8], and twice as likely to achieve or maintain suppression (adjusted odds ratio 2.1; 95% CI 1.1–4.0).


Llevamos a cabo un ensayo controlado con asignación aleatoria para determinar si la pronta reubicación de personas con VIH/SIDA sin hogar puede mejorar la condición de su estado de vivienda y la supresión viral del VIH más que la asistencia de reubicación básica. Reclutamos 236 personas con VIH/SIDA que residen en viviendas de emergencia para personas con VIH en la Ciudad de Nueva York y las asignamos aleatoriamente para: 1) Servicio de asistencia mejorada, es decir, asignación a un consejero para que rápidamente realoje al cliente y provee 12 meses de servicios sociales o 2) Servicios usuales de asistencia, es decir, referidos a un programa de colocación de vivienda de la Ciudad de Nueva York donde todos los residentes de viviendas de emergencia con VIH eran elegibles. Comparamos el tiempo de la reubicación a vivienda estable y el porcentaje de supresión de la carga viral desde la línea de base hasta 12 meses. Los clientes asignados a servicio de asistencia mejorada fueron colocados más rápido que los clientes asignados a servicios usuales de asistencia (p = 0.02; 25% colocado dentro de 150 días vs. 243 días, respectivamente), tuvieron mayor probabilidad de ser asignados a una vivienda estable (proporción de riesgos ajustada = 1.8; intervalo de confianza del 95% [IC] = 1.1-2.8), y tuvieron doble probabilidad de lograr o mantener la supresión de la carga viral (proporción de probabilidades ajustado = 2.1; 95% IC = 1.1-4.0).

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First and foremost, the authors thank the housing consumers, who offered us time, patience, and honesty. Their participation and candor made it possible to conduct this study. We are also grateful to the staff of CitiWide Harm Reduction (now BOOM!Health) who participated in recruitment and case management, particularly Sandy Guillaume. We also thank the New York City HIV/AIDS Services Administration (HASA) for collaborating with us to help consumers of emergency housing transition to more stable living situations. The authors also thank current and former staff of the Housing Services Unit of the New York City Department of Health and Mental Hygiene, including Giovanna Novoa, Laura McAllister-Hollod, Roland Torres, Dave Magno, X. Pamela Farquhar, Christopher M. Beattie, and Joanne Hsu, who helped with study administration, conduct, monitoring, analysis, and/or interpretation. Thank you to evaluation interns from the Columbia University Mailman School of Public Health who helped interview consumers: Jenny Doyle, Michelle Dixon, Lorlette Haughton, Lindsay DuBois, Abigail Greenleaf, and Hannah Cohen-Blair. Finally, we thank Eleonora Jimenez-levi, Raquel Silverio, and Dr. Luis Roberto Rodriguez-Porras for their assistance in preparing the Spanish abstract.


The study’s evaluation was covered through existing responsibilities of staff at the New York City Department of Health and Mental Hygiene.

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Correspondence to Ellen Weiss Wiewel.

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All the authors declared that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Research Involving Human Participants and/or Animals

All procedures performed involving human participants were in accordance with the ethical standards of the 1964 Helsinki declaration, its later amendments, and the New York City Department of Health and Mental Hygiene, and were reviewed and approved by that agency’s Institutional Review Board. The study has been registered on (record ID: NCT03334825). This article does not contain any studies with animals performed by any of the authors.

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Towe, V.L., Wiewel, E.W., Zhong, Y. et al. 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 23, 2315–2325 (2019).

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