This is a study of the relationships between gender, housing status, drug use, mental illness and health service utilization, as well as their impact on health status in a population of HIV-infected marginally housed individuals.
The specific aims of the study are as follows: 1) To examine health service utilization (i.e., primary care, drug treatment, and mental health services) in a cohort of HIV-infected homeless and marginally individuals, and to determine differences in the patterns of health service utilization between women and men at baseline as well as over a 28 month follow-up period; 2) To examine health outcomes (physical and mental) in a cohort of HIV-infected homeless and marginally housed individuals, and to determine the extent to which women experience differences in health outcomes from men at baseline as well as over a 28 month follow-up period; and 3) To determine predisposing, enabling, and need factors influencing the differences that HIV-infected homeless and marginally housed women experience in health service utilization and health status. To achieve these specific aims, the following activities will be accomplished: 1) recruit an additional 50 women into a preexisting cohort in order to increase statistical power for gender comparisons; (2) add detailed drug use, health, victimization, subsistence needs, and health service utilization variables to the existing REACH questionnaire; (3) implement a new SCID diagnostic assessment to thoroughly assess mental health; (4) employ the use of electronic health service databases to conduct new validity studies; and (5) conduct analyses specific to these new areas of interest. Achieving the proposed specific aims will only be possible with the addition of these new activities that will ultimately yield a new class of analyses. A detailed study of the impact and interactions of gender, drug use, mental illness, health service use, competing needs like access to food, and health status will lead to a better understanding of ongoing mortality among HIV-infected marginally housed individuals and create the foundation for more effective health interventions in a variety of settings. ? ?

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Application #
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Jones, Dionne
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Budget Start
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Meacham, Meredith C; Bahorik, Amber L; Shumway, Martha et al. (2018) Condomless Sex and Psychiatric Comorbidity in the Context of Constrained Survival Choices: A Longitudinal Study Among Homeless and Unstably Housed Women. AIDS Behav :
Meacham, Meredith C; Ramo, Danielle E; Kral, Alex H et al. (2018) Associations between medical cannabis and other drug use among unstably housed women. Int J Drug Policy 52:45-51
Kim, Jin E; Flentje, Annesa; Tsoh, Janice Y et al. (2017) Cigarette Smoking among Women Who Are Homeless or Unstably Housed: Examining the Role of Food Insecurity. J Urban Health 94:514-524
Young, Dmitri A; Shumway, Martha; Flentje, Annesa et al. (2017) The relationship between childhood abuse and violent victimization in homeless and marginally housed women: The role of dissociation as a potential mediator. Psychol Trauma 9:613-621
Flentje, Annesa; Shumway, Martha; Wong, Lauren H et al. (2017) Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses. Womens Health Issues 27:294-301
Riley, Elise D; Evans, Jennifer L; Hahn, Judith A et al. (2016) A Longitudinal Study of Multiple Drug Use and Overdose Among Young People Who Inject Drugs. Am J Public Health 106:915-7
Riley, Elise D; Cohen, Jennifer; Dilworth, Samantha E et al. (2016) Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment. Sex Transm Infect 92:305-8
Riley, Elise D; Kral, Alex H; Cohen, Jennifer et al. (2016) Levamisole-Contaminated Cocaine Use in HIV-Infected and Uninfected Unstably Housed Women. J Womens Health (Larchmt) 25:936-43
Wong, Lauren H; Shumway, Martha; Flentje, Annesa et al. (2016) Multiple Types of Childhood and Adult Violence Among Homeless and Unstably Housed Women in San Francisco. Violence Vict 31:1171-1182
Riley, Elise D; Shumway, Martha; Knight, Kelly R et al. (2015) Risk factors for stimulant use among homeless and unstably housed adult women. Drug Alcohol Depend 153:173-9

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