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Randomized controlled trial of housing placement assistance for homeless persons with HIV
Approximately 800 persons living with HIV/AIDS (PLWHA) reside in HIV emergency single-room-occupancy (SRO) hotels in New York City and do not have the ability to secure permanent housing on their own. The study evaluated a pilot program which fast-tracked PLWHA from HIV emergency SRO hotels into permanent housing. The Enhanced Housing Placement Assistance (EHPA) program had three components: 1) active recruitment of emergency SRO hotel residents with high need for housing; 2) assistance in the rapid (fast-track) acquisition of permanent housing; and 3) participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability. Participants were randomly assigned to either 1) EHPA or 2) usual care, which included standard connections to services and housing programs offered by the New York City HIV/AIDS Services Administration (HASA), Housing Opportunities for Persons With AIDS (HOPWA), or Ryan White services, and were followed over twelve months using a questionnaire developed with significant input from the target population of PLWHA residing in emergency SRO hotels.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Enhanced housing placement assistance | Experimental |
| |
| Standard housing placement assistance | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced housing placement assistance | Other | assistance in the rapid (fast-track) acquisition of permanent housing; and participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Placement in Permanent Housing | supportive housing, rental assistance, other non-emergency housing, etc. | 12 months post-enrollment |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Engagement in HIV Care | any reported HIV viral load (VL) or CD4 test | 12 months post-enrollment |
| Number of Participants With HIV Viral Suppression | Last viral load is under 200 copies/mL |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ellen W Wiewel, DrPH | New York City Department of Health and Mental Hygiene | Principal Investigator |
| Vivian L Towe, PhD | RAND | Principal Investigator |
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The study team recruited participants onsite at 22 HIV emergency single adult shelters across NYC between April 2012 and April 2013
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| ID | Title | Description |
|---|---|---|
| FG000 | Enhanced Housing Placement Assistance | Enhanced housing placement assistance: assistance in the rapid (fast-track) acquisition of permanent housing; and participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability |
| FG001 | Standard Housing Placement Assistance | Standard housing placement assistance: standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Enhanced Housing Placement Assistance | Enhanced housing placement assistance: assistance in the rapid (fast-track) acquisition of permanent housing; and participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Placement in Permanent Housing | supportive housing, rental assistance, other non-emergency housing, etc. | persons who survived 12 months post-enrollment | Posted | Count of Participants | Participants | 12 months post-enrollment |
|
12 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Enhanced Housing Placement Assistance | assistance in the rapid (fast-track) acquisition of permanent housing; and participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability Enhanced housing placement assistance: assistance in the rapid (fast-track) acquisition of permanent housing; and participation in a 12-month support services program designed to prevent PLWHA from relapsing into homelessness, with services focused on increasing clients' capacity to live independently and maintain housing stability |
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Rates of viral suppression at baseline were unequal between the two study arms, in spite of randomization.
Electronically reported laboratory test data does not distinguish routine vs. acute medical care.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Ellen Wiewel | New York City Department of Health and Mental Hygiene | 347-396-7653 | ewiewel@health.nyc.gov |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 1, 2012 | Sep 6, 2018 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Apr 5, 2012 | Sep 6, 2018 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
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randomized controlled trial
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|
| Standard housing placement assistance | Other | standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White |
|
| 12 months post-enrollment |
| BG001 | Standard Housing Placement Assistance | Standard housing placement assistance: standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex/Gender, Customized | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Placement in Permanent Housing | Persons were sampled for this study from emergency housing. Therefore, by design, none were placed in permanent housing at baseline. | Count of Participants | Participants |
|
| Engagement in HIV Care | any reported HIV viral load (VL) or CD4 test within 12 months pre-enrollment | One person enrolled in the EHPA arm had baseline interview data but could not be matched with the HIV surveillance registry, which provided laboratory test results indicative of HIV care and viral suppression, so care and suppression characteristics could not be obtained for this one person | Count of Participants | Participants |
|
| HIV Viral Suppression | Last viral load is under 200 copies/mL in the 12 months pre-enrollment | One person enrolled in the EHPA arm had baseline interview data but could not be matched with the HIV surveillance registry, which provided laboratory test results indicative of HIV care and viral suppression, so care and suppression characteristics could not be obtained for this one person | Count of Participants | Participants |
|
Standard housing placement assistance: standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White |
|
|
| Secondary | Number of Participants With Engagement in HIV Care | any reported HIV viral load (VL) or CD4 test | persons who survived 12 months post-enrollment | Posted | Count of Participants | Participants | 12 months post-enrollment |
|
|
|
| Secondary | Number of Participants With HIV Viral Suppression | Last viral load is under 200 copies/mL | persons who survived 12 months post-enrollment | Posted | Count of Participants | Participants | 12 months post-enrollment |
|
|
|
| 6 |
| 119 |
| 0 |
| 119 |
| 0 |
| 119 |
| EG001 | Standard Housing Placement Assistance | standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White Standard housing placement assistance: standard connections to services and housing programs offered by HASA, HOPWA, or Ryan White | 4 | 117 | 0 | 117 | 0 | 117 |
All PIs have been employed by the New York City Department of Health and Mental Hygiene. Dr. Towe is no longer at the New York City Department of Health and Mental Hygiene and is currently at RAND Corporation. Any results communications must be cleared by the New York City Department of Health and Mental Hygiene prior to public release.
| D015229 |
| Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |