Poverty Blocks Progress Against HIV

Basic unmet needs undermines fight against HIV for homeless

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) There's been a lot of good news for HIV patients in the past few years, with progress towards better drugs and treatment. But the good news hasn't yet reached America's urban poor.

A new study has found that basic unmet needs – a lack of food, stable housing, or hygiene – undermines progress in the fight against HIV among impoverished and HIV-positive patients.

In fact, the inability to meet these basic needs had a bigger influence on overall health than how they managed their virus.

"Basic needs must be met before HIV can be eradicated."

The study was led by Elise Riley, PhD, Associate Professor in the University of California – San Francisco's HIV/AIDS Division at San Francisco General Hospital and Trauma Center. It is published in the open access journal PloS One.

Dr. Riley and her team wanted to investigate the challenges that impoverished, HIV-positive populations face when it comes to their overall health. People who have unstable housing situations or are homeless are disproportionately impacted by social and structural barriers to HIV treatment.

They focused in on a group of 288 homeless and “unstably housed” men living in San Francisco, and followed them for six years. A minority of study participants were taking antiretroviral therapy (ART), the drugs that lower the amount of HIV in the patient's blood, a measure known as viral load.

In a statement, Dr. Riley said, “More importantly, while viral load was one of the most important predictors of overall health, we found that an inability to meet basic subsistence needs had an even larger influence on health status in this population.”

In other words, while HIV obviously has a strong influence on an individual's health, a lack of food, shelter, and hygiene plays an even bigger role in that person's overall health.

For patients who were getting HIV treatment, homelessness and/or instability undermined the positive effects of the medication. In many cases, the mens' situation kept them from receiving consistent treatment.

The bottom line is that for those who wonder where they are going to sleep or eat each day, getting care is less of a priority.

The study's results illustrate the point that treating HIV and eventually ending the HIV/AIDS epidemic is not just a matter of getting medications into people who need them. There needs to be opportunities for people to meet their basic needs, along with access to care and drugs, says Dr. Riley.

The findings from this study are consistent with a similar study that Dr. Riley's team conducted with homeless women, which was published last year.

This study was published in April 2012.

Reviewed by: 
Review Date: 
April 26, 2012
Last Updated:
April 30, 2012