Prevalent and incident homelessness among a prospective cohort of black and white non-Hispanic men who have sex with men in Atlanta, GA Open Access

Taylor, Calli (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/r781wg822?locale=en
Published

Abstract

Background: Homelessness is an endemic issue in the United States that disproportionately impacts certain populations, including African Americans and men who have sex with men (MSM). Herein we report on the prevalence and incidence of homelessness among men who have sex with men in Atlanta.

Methods: Data from the InvolveMENt study, a prospective cohort study of black and white Atlanta MSM that took place between June 2010 and March 2014, were used for this study. Baseline data (n=803) were used for prevalence analyses, while prospective data from HIV- negative MSM (n=556) were used for descriptive analyses and to estimate homelessness incidence rates. Significant predictors of homelessness incidence were determined using proportional hazards modeling.

Results: Among the baseline cohort, 93 (11.6%) MSM reported any prevalent homelessness, and black MSM were more likely to report prevalent homelessness than white MSM (15.2% and 6.9%, chi-square p=0.0003). Prevalent homelessness was higher among HIV-positive participants than among HIV-negative participants at baseline (17.4% and 9.0%, chi-square p=0.0006). Among the prospective cohort, there were 42 MSM who had incidence of homelessness, a rate of 5.9 per 100 person-years. Compared to white MSM, black MSM were twice as likely to have become homeless (RR: 2.1, 95% CI: 1.1, 4.1). Depressive symptoms (RR: 2.9, 95% CI: 1.6, 5.4), and age (RR: 2.4, 95% CI: 1.3, 4.5) were also found to be associated with incident homelessness.

Conclusions: Our results provided previously unreported homelessness prevalence and incidence measures of MSM in Atlanta, allowing for an examination of predictive factors of incident homelessness and providing a foundation for further research on this topic. Race, age, and depressive symptoms were found to be predictors of incident homelessness among this population. The estimates reported in this study emphasize the need for preventative programs and services focused on African American MSM, young MSM, and those with mental health disorders.

Table of Contents

Introduction ................................................................................................................... 1

Methods ........................................................................................................................ 3

Results .......................................................................................................................... 7

Discussion ..................................................................................................................... 9

Tables

Table 1. Prevalent homelessness at baseline, by HIV status, among black and
white non-Hispanic MSM followed in an incidence cohort, Atlanta 2010-2014
................. 14

Table 2. Baseline characteristics of 556 black and white non-Hispanic MSM
followed in an incidence cohort, Atlanta, 2010-2014
................................................... 15

Table 3. Predictors of incident homelessness in 556 black and white non-
Hispanic MSM followed in an incidence cohort, Atlanta, 2010-201
................................. 16

Table 4. Adjusted black-white hazard ratios for homelessness from multivariable

models, in an incidence cohort of 556 black and white non-Hispanic MSM,

Atlanta, 2010-2014 ................................................................................................ 18

Figures

Figure 1 Kaplan Meier plot illustrating incident homelessness in 556 black
and white non-Hispanic MSM followed in an incidence cohort, Atlanta,
2010-2014
............................................................................................................ 19

Figure 2 Kaplan Meier plot illustrating incident homelessness, by race, in
556 black and white non-Hispanic MSM followed in an incidence cohort,
Atlanta, 2010-2014
................................................................................................ 19

Figure 3 Kaplan Meier plot illustrating incident homelessness, by age, in
556 black and white non-Hispanic MSM followed in an incidence cohort,
Atlanta, 2010-2014
................................................................................................ 20

Figure 4 Kaplan Meier plot illustrating incident homelessness, by depressive
symptoms, in 556 black and white non-Hispanic MSM followed in an incidence
cohort, Atlanta, 2010-2014
..................................................................................... 20

Figure 5 Kaplan Meier plot illustrating incident homelessness, by race and
age, in 556 black and white non-Hispanic MSM followed in an incidence
cohort, Atlanta, 2010-2014
..................................................................................... 21

References .................................................................................................................... 22

Appendices

Appendix A. SAS Code ............................................................................................ 26

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