Advertisement

 

 

Housing Stability and Medication Adherence among HIV-Positive Individuals in Antiretroviral Therapy: A Meta-Analysis of Observational Studies in the United States.

Housing Stability and Medication Adherence among HIV-Positive Individuals in Antiretroviral Therapy: A Meta-Analysis of Observational Studies in the United States.
Author Information (click to view)

Harris RA, Xue X, Selwyn PA,


Harris RA, Xue X, Selwyn PA, (click to view)

Harris RA, Xue X, Selwyn PA,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Journal of acquired immune deficiency syndromes (1999) 74(3) 309-317 doi 10.1097/QAI.0000000000001213

Abstract
BACKGROUND
Previous research has produced inconsistent evidence of an association between housing stability and medication adherence among HIV-positive individuals in antiretroviral therapy.

OBJECTIVE
We conducted a meta-analysis of the housing-adherence relationship based on a comprehensive search of observational studies in the PubMed, Embase, and Cochrane databases (January 2000-January 2016). Ten qualifying studies were identified representing 10,556 individuals.

METHODS
A random-effects model was used to estimate the overall effect size and 95% confidence interval (CI). Robustness of the estimate was determined by sensitivity analysis. Heterogeneity was assessed by meta-regression analysis, subgroup analysis, and quality effects estimation. Publication bias was evaluated with a funnel plot and the Egger and Begg tests.

RESULTS
The summary effect for the association between housing stability and medication adherence was positive and significant (standardized mean difference = 0.15, 95% CI: 0.02 to 0.29). The association was slightly larger in the quality effects analysis (standardized mean difference = 0.20, 95% CI: 0.01 to 0.39). Sensitivity analysis disclosed that the association was robust at the P = 0.09 level. Results of the subgroup and meta-regression analyses were nonsignificant. Publication bias was not detected.

CONCLUSION
Antiretroviral medication adherence is an increasing function of housing stability, but the magnitude of the effect is small. The finding challenges the view that unstable housing is incompatible with adherence and questions the potential benefit of deferring antiretroviral therapy initiation until the patient’s housing circumstances are improved.

Submit a Comment

Your email address will not be published. Required fields are marked *

10 + 5 =

[ HIDE/SHOW ]