AEGiS-11IAC: Survival after AIDS among outcasts in Rio de Janeiro, Brazil. Importance of housing homeless AIDS patients.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Survival after AIDS among outcasts in Rio de Janeiro, Brazil. Importance of housing homeless AIDS patients.

Int Conf AIDS 1996 Jul 7-12; 11:461 (abstract no. Pub.C.1144)
Linhares-Carvalho MI, Pontes M, Souza CR, Castello-Branco LR; Ambultorio da Providencia da Arquidocese do Rio, Rio de Janeiro, Brazil. Fax: 5521-55244 97.

INTRODUCTION: Homelessness has been recognised as an important public health problem. Homeless persons have an increased risk of HIV infection because of a high prevalence of HIV-related risk behaviours. Some 65% of all patients (11,000) that attend our outpatient clinic are homeless. Some of these subjects, when found they were HIV+, agreed to be housed at Santo Antonio Support House - SASH- we run for HIV+ subjects. At SASH is offered rooms, meals and medicine needs and a multidisciplinary team provides medical, emotional, psychosocial and religious support as well as occupational therapy.

OBJECTIVES: We intended to compare, in a prospective study, survival time between homeless and ex-homeless housed persons with AIDS in Rio de Janeiro from 1990 to 1995. For this we studied HIV+ homeless subjects and HIV+ volunteers that previously lived on the streets and agreed to be housed at SASH.

METHODS: All subjects attended a charitable medical clinic in Rio de Janeiro run by the Catholic Church. A control group was formed by HIV-1 + subjects that lived with their relatives and came from the poorest section of Rio society. All volunteers were seen by the same team of doctors and had access to the same treatment. Survival time of each patient was calculated from the date of AIDS diagnosis until the date of death. Patients were divided into three groups: 1- Homeless, 2- Ex-homeless housed and 3- Housed patients.

RESULTS: In the homeless group 27 patients were seen (26 male), mean age 34 years (range 23 to 49) and mean survival was 8.2 months (range 1 to 33). In the ex-homeless group 26 patients were seen (16 male), mean age 38 years (22 to 61) and mean survival was 17.8 months (1 to 48). In the Control group 59 patients were seen (47 male), mean age 34 (19 to 66) and mean survival time was 18.3 months (2 to 60).

CONCLUSION: This study indicates a significant difference in survival time between the homeless and non-homeless groups. The mean survival time amongst ex-homeless patients is similar to the patients that lived with relatives and twice as high than that observed for the homeless patients. Better nutrition and hygienic habits, more frequent medical and psychological care together with controlled medication, occupational therapy, decrease in promiscuity, alcohol and drug abuse and religious support may explain the difference in survival observed in these groups. In conclusion, these data suggest that appropriate housing facilities together with appropriate clinical strategies should be provided to homeless HIV1 infected persons.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Homeless Persons, Housing, HIV Infections, Risk-Taking, Poverty, Prevalence, Health Services Needs and Demand, Survival Rate, Prospective Studies, Brazil, Male, Human, mortality, ICA11

960707
PubC1144