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Residential Eviction and Risk of Detectable Plasma HIV-1 RNA Viral Load Among HIV-Positive People Who Use Drugs Kennedy, Mary Clare; Kerr, Thomas; Parashar, Surita; McNeil, Ryan, 1982-; Montaner, Julio; Wood, Evan; Milloy, M-J

Abstract

We examined the relationship between residential eviction and exhibiting detectable plasma HIV-1 RNA viral load (VL) among a prospective cohort of antiretroviral therapy (ART)-exposed HIV-seropositive people who use illicit drugs (PWUD) in Vancouver, Canada. We used multivariable generalized estimating equations to estimate the effect of residential eviction on detectable VL and examine ART adherence as a mediating variable. Between June 2007 and May 2014, 705 ART-exposed participants were included in the study, among whom 500 (70.9%) experienced at least one period of detectable VL. In a time-updated multivariable model, eviction independently increased the odds of detectable VL among those who were homeless (adjusted odds ratio [AOR] = 2.25; 95% confidence interval [CI]: 1.18 – 4.29) as well as not homeless (AOR = 1.76; 95% CI: 1.17 – 2.63) post eviction. The results of mediation analyses suggest that this association was mediated by incomplete ART adherence. These findings suggest the need for further development and evaluation of interventions to prevent evictions and promote ART adherence among PWUD facing eviction.

Item Metadata

Title
Residential Eviction and Risk of Detectable Plasma HIV-1 RNA Viral Load Among HIV-Positive People Who Use Drugs
Creator
Kennedy, Mary Clare; Kerr, Thomas; Parashar, Surita; McNeil, Ryan, 1982-; Montaner, Julio; Wood, Evan; Milloy, M-J
Contributor
British Columbia Centre for Excellence in HIV/AIDS
Date Issued
2017-03-21
Description
We examined the relationship between residential eviction and exhibiting detectable plasma HIV-1 RNA viral load (VL) among a prospective cohort of antiretroviral therapy (ART)-exposed HIV-seropositive people who use illicit drugs (PWUD) in Vancouver, Canada. We used multivariable generalized estimating equations to estimate the effect of residential eviction on detectable VL and examine ART adherence as a mediating variable. Between June 2007 and May 2014, 705 ART-exposed participants were included in the study, among whom 500 (70.9%) experienced at least one period of detectable VL. In a time-updated multivariable model, eviction independently increased the odds of detectable VL among those who were homeless (adjusted odds ratio [AOR] = 2.25; 95% confidence interval [CI]: 1.18 – 4.29) as well as not homeless (AOR = 1.76; 95% CI: 1.17 – 2.63) post eviction. The results of mediation analyses suggest that this association was mediated by incomplete ART adherence. These findings suggest the need for further development and evaluation of interventions to prevent evictions and promote ART adherence among PWUD facing eviction.
Subject
illicit drug use; housing eviction; detectable plasma viral load; HIV/AIDS; Canada
Geographic Location
Downtown-Eastside (Vancouver, B.C.)
Genre
Article
Type
Text
Language
eng
Date Available
2018-04-17
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0365728
URI
http://hdl.handle.net/2429/65433
Affiliation
Medicine, Faculty of; Medicine, Department of; Population and Public Health (SPPH), School of
Citation
Kennedy, M.C., Kerr, T., McNeil, R., Parashar, S., Montaner, J., Wood, E., and Milloy, M.-J. (2017). Residential Eviction and Risk of Detectable Plasma HIV-1 RNA Viral Load Among HIV-Positive People Who Use Drugs. AIDS and Behavior 21(3): 678-687.
Publisher DOI
10.1007/s10461-016-1315-z.
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International