Table 3.

Prevalence of Subsistence Needs and Clinical Outcomes, Overall and by Homeless and Housing Instability During the Past 12 Months Among Persons With Diagnosed HIV—Medical Monitoring Project, United States, 2018 (N = 4,050)

Characteristica	Unstably Housed						Unstably Housed Only (Not Homeless)
	Yes		No		PR (95% CI)	p	Yes		No		PR (95% CI)	p
	n b	Col% (CI)c	n b	Col% (CI)c			n b	Col% (CI)c	n b	Col% (CI)c
Total (row%)	870	21.0 (19.5–22.6)	3,157	79.0 (77.4–80.5)			471	11.5 (10.0–13.1)	3,552	88.5 (86.9–90.0)
Received shelter or housing services
Needed but did not receive	255	29.4 (24.9–33.9)	197	6.0 (5.0–6.9)	4.94 (4.12–5.92)	< 0.001	127	26.3 (22.4–30.1)	324	8.9 (7.5–10.2)	2.96 (2.48–3.54)	< 0.001
Received	239	26.0 (22.1–29.9)	468	14.6 (12.6–16.6)	1.78 (1.50–2.12)	< 0.001	85	16.4 (13.0–19.7)	620	17.0 (15.1–19.0)	0.96 (0.80–1.16)	0.676
Did not need and did not receive	367	44.6 (41.1–48.0)	2,473	79.5 (77.3–81.6)	0.56 (0.52–0.60)	< 0.001	258	57.4 (52.9–61.8)	2,581	74.1 (71.9–76.3)	0.77 (0.72–0.83)	< 0.001
Experienced food insecurity
Yes	402	46.1 (42.7–49.6)	396	12.3 (10.9–13.7)	3.76 (3.24–4.36)	< 0.001	178	38.4 (33.5–43.4)	616	16.8 (15.4–18.2)	2.29 (1.96–2.67)	< 0.001
No	468	53.9 (50.4–57.3)	2,757	87.7 (86.3–89.1)	0.61 (0.57–0.66)	< 0.001	293	61.6 (56.6–66.5)	2,932	83.2 (81.8–84.6)	0.74 (0.68–0.80)	< 0.001
Retained in care
Yes	651	72.4 (68.0–76.9)	2,567	80.0 (77.8–82.2)	0.91 (0.85–0.96)	< 0.001	360	75.3 (70.2–80.3)	2,856	78.8 (76.7–80.9)	0.96 (0.90–1.02)	0.120
No	173	27.6 (23.1–32.0)	435	20.0 (17.8–22.2)	1.38 (1.16–1.63)	< 0.001	91	24.7 (19.7–29.8)	516	21.2 (19.1–23.3)	1.17 (0.96–1.41)	0.120
ART prescription
Yes	730	78.3 (75.0–81.6)	2,740	82.0 (79.9–84.1)	0.95 (0.92–0.99)	0.014	406	81.9 (77.4–86.4)	3,061	81.2 (79.1–83.4)	1.01 (0.96–1.06)	0.763
No	140	21.7 (18.4–25.0)	417	18.0 (15.9–20.1)	1.21 (1.04–1.40)	0.014	65	18.1 (13.6–22.6)	491	18.8 (16.6–20.9)	0.96 (0.76–1.22)	0.763
100% ART dose adherence, past 30 days
Yes	377	45.1 (40.3–49.9)	1,900	62.7 (60.7–64.7)	0.72 (0.65–0.79)	< 0.001	212	45.9 (40.7–51.2)	2,064	61.0 (58.8–63.1)	0.75 (0.68–0.84)	< 0.001
No	411	54.9 (50.1–59.7)	1,130	37.3 (35.3–39.3)	1.47 (1.36–1.59)	< 0.001	222	54.1 (48.8–59.3)	1,319	39.0 (36.9–41.2)	1.38 (1.27–1.51)	< 0.001
Sustained viral suppressiond
Yes	441	46.3 (42.4–50.3)	2,248	66.6 (63.8–69.3)	0.70 (0.65–0.75)	< 0.001	261	52.3 (45.9–58.6)	2,425	63.7 (60.8–66.5)	0.82 (0.73–0.92)	< 0.001
No	429	53.7 (49.7–57.6)	909	33.4 (30.7–36.2)	1.61 (1.49–1.73)	< 0.001	210	47.7 (41.4–54.1)	1,127	36.3 (33.5–39.2)	1.31 (1.16–1.49)	< 0.001
Emergency department visits
0	361	44.7 (40.4–49.0)	1,943	62.1 (59.5–64.6)	0.72 (0.66–0.79)	< 0.001	223	50.0 (44.2–55.7)	2,079	59.6 (57.0–62.1)	0.84 (0.75–0.94)	0.001
1	174	21.0 (17.8–24.2)	580	18.7 (16.9–20.5)	1.12 (0.96–1.30)	0.146	101	22.0 (18.4–25.6)	653	18.9 (16.9–20.8)	1.17 (0.95–1.43)	0.140
2–4	255	26.1 (23.3–28.9)	524	16.1 (14.6–17.6)	1.62 (1.42–1.85)	< 0.001	120	22.8 (18.7–26.9)	658	17.6 (16.1–19.0)	1.30 (1.08–1.57)	0.008
≥5	77	8.2 (6.4–10.1)	103	3.1 (2.4–3.9)	2.62 (1.96–3.50)	< 0.001	25	5.2 (2.4–7.9)	154	4.0 (3.3–4.7)	1.29 (0.77–2.16)	0.341
Hospitalizations
0	603	72.8 (69.1–76.6)	2,591	82.8 (80.7–84.9)	0.88 (0.83–0.93)	< 0.001	352	77.5 (72.2–82.9)	2,839	81.1 (79.1–83.0)	0.96 (0.89–1.02)	0.168
1	123	13.7 (11.0–16.5)	335	10.7 (8.9–12.5)	1.28 (1.01–1.63)	0.038	68	13.6 (9.5–17.8)	390	11.1 (9.3–12.8)	1.23 (0.87–1.75)	0.245
2–4	118	11.3 (9.0–13.6)	196	5.6 (4.9–6.4)	2.00 (1.57–2.56)	< 0.001	44	7.6 (4.6–10.6)	269	6.7 (6.0–7.5)	1.13 (0.76–1.67)	0.544
≥5	22	2.1 (1.3–2.9)	28	0.9 (0.5–1.3)	2.42 (1.29–4.51)	0.006	—e	—	44	1.1 (0.8–1.5)	—	—
Depression, past 2 weeksf
No depression	612	70.2 (66.0–74.4)	2,673	85.6 (84.2–87.0)	0.82 (0.77–0.88)	< 0.001	354	74.8 (70.4–79.1)	2,931	83.4 (82.0–84.8)	0.90 (0.84–0.95)	< 0.001
Major or other depression	242	29.8 (25.6–34.0)	448	14.4 (13.0–15.8)	2.07 (1.72–2.50)	< 0.001	114	25.2 (20.9–29.6)	575	16.6 (15.2–18.0)	1.52 (1.24–1.87)	< 0.001
Generalized anxiety disorder, past 2 weeksg
No or mild anxiety	605	70.3 (66.4–74.1)	2,744	87.2 (84.9–89.5)	0.81 (0.77–0.85)	< 0.001	356	75.5 (70.0–81.0)	2,993	84.8 (82.5–87.0)	0.89 (0.83–0.95)	< 0.001
Moderate to severe anxiety	251	29.7 (25.9–33.6)	387	12.8 (10.5–15.1)	2.33 (1.96–2.77)	< 0.001	112	24.5 (19.0–30.0)	525	15.2 (13.0–17.5)	1.61 (1.29–2.01)	< 0.001

Note. ART = antiretroviral therapy; CI = confidence interval; GAD-7 = Generalized Anxiety Disorder-7.

^aAll variables were self-reported and measured over the past 12 months, except where otherwise indicated.

^bNumbers are unweighted.

^cPercentages and corresponding CIs are weighted.

^dAll viral load measurements documented undetectable or <200 copies/mL.

^eCoefficient of variation ≥0.3. Data suppressed. Estimate is unstable.

^fDepression was assessed using the Patient Health Questionnaire (PHQ-8); responses to the items on the PHQ-8 were used to define “major depression” and “other depression” according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4^th edition (DSM–IV). “Major depression” was defined as having at least five symptoms of depression; “other depression” was defined as having two to four symptoms of depression. Major depression and other depression were combined into a single category.

^gResponses to the GAD-7 were used to define “mild anxiety,” “moderate anxiety,” and “severe anxiety” according to the criteria from the DSM-IV. “Severe anxiety” was defined as having a score of ≥15; “moderate anxiety” was defined as having a score of 10 to 14; and “mild anxiety” was defined as having a score of 5 to 9. For this analysis, no anxiety and mild anxiety were combined into a single category, and moderate anxiety and severe anxiety were combined into a single category.