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Heterogeneous preferences for care engagement among people with HIV experiencing homelessness or unstable housing during the COVID-19 pandemic

Citation

Imbert E, Hickey MD, Del Rosario JB, et al. Brief Report: Heterogeneous Preferences for Care Engagement Among People With HIV Experiencing Homelessness or Unstable Housing During the COVID-19 Pandemic. J Acquir Immune Defic Syndr. 2022;90(2):140-145. doi:10.1097/QAI.0000000000002929

Implementation stage:

Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

Viral suppression

Geography:

Alameda County-CA

Study Participant Classification:

Community member(s)

Plain Language Objectives

The researchers asked people with HIV and unstable housing in San Francisco which clinic features mattered most during the pandemic. They wanted to compare preferences for flexible visits, consistent providers, incentives, telehealth, locations, and navigation support.

Plain Language Abstract

People with HIV who lack stable housing have much lower viral suppression than housed patients, and care models may not match their priorities. Researchers conducted a choice experiment with 115 San Francisco patients experiencing homelessness or unstable housing; 40% lived outdoors. Participants compared hypothetical services differing in provider continuity, visit incentives, location, scheduled versus drop-in care, telehealth, and navigation. On average, the strongest preferences were seeing the same provider, receiving visit incentives, and having drop-in visits. Optional telehealth was not preferred. Analysis identified two groups: 78 participants (68%) preferred a flexible care model, while 37 (32%) placed greater value on a single consistent provider. The results show that this population did not have one uniform preference and that offering choices may matter. Because participants selected hypothetical service combinations during the COVID-19 pandemic, the study did not measure whether preferred features increased attendance or viral suppression. Findings from one public clinic may not apply to all people experiencing unstable housing.

Key Takeaways

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Publications

Barriers/Facilitators

Science Frameworks

Implementation Science Frameworks

Outcomes

Community Partnerships

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This dashboard provides an accessible way to explore national and jurisdictional findings from implementation science research supporting the Ending the HIV Epidemic initiative. The homepage gives you quick access to major sections of the site and highlights key insights drawn from ongoing research and community partnerships.

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