Quantifying the Risk for Homelessness Among HIV Positive MSM Using the American Men’s Internet Survey Open Access
Fox, Shannon (Spring 2019)
Published
Abstract
Introduction
The World Health Organization identified housing as a basic determinant of health. Studies have also shown that people with unstable housing are associated with an elevated risk of HIV due to increased risky behavior, and HIV disproportionately affects men who have sex with men (MSM). MSM have been found to be more likely to engage in behaviors such as unprotected sex during periods of heavy substance use. This study aims to quantify the risk of experiencing homelessness among HIV positive MSM through the American Men’s Internet Survey (AMIS).
Methods
AMIS is an internet survey directed at men who have sex with men throughout America. Data was pulled from the fourth completed cycle of the survey from February 2017, and univariate and multivariate associations with homelessness were assessed among 857 HIV positive MSM for demographic, behavioral, and social determinant risk factors using logistic regression.
Results
Among the 7,819 MSM included in the study, 481 (6.15%) reported having unstable housing. A univariate analysis showed that MSM with HIV were 1.6 times more likely to be homeless compared to HIV negative MSM. MSM who are black, living below the poverty line, experienced stigma, injection drug users, and exchanged money or drugs for sex were all found to be risk factors. In multivariate analyses, HIV was no longer a statistically significant risk factor for unstable housing. However, black MSM, those with a high school degree or less, those living below the poverty line, weekly injection drug users, men who received money or drugs for sex, and men who felt stigma all remained as independent risk factors for unstable housing.
Discussion
In this analysis, MSM living with HIV were not significantly more likely to have unstable housing after controlling for race, drug use, and other social and behavioral risk factors. Black MSM experienced some of the highest rates of homelessness, as did those who used injection drugs weekly. Further studies are needed to evaluate the association between HIV and homelessness and prevention programs for vulnerable populations like MSM are needed.
Table of Contents
Table of Contents
Introduction………………………………………………………………………..1-3
Methods……………………………………………………………………………..4-5
Results……………………………………………………………………………….6-8
Discussion…………………………………………………………………………..9-12
References………………………………………………………………………….13-16
Tables………………………………………………………………………………..17-22
About this Master's Thesis
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