{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T04:21:57Z","timestamp":1782879717178,"version":"3.54.5"},"reference-count":14,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[2001,7,1]]},"abstract":"\n STUDY OBJECTIVE<\/jats:title>\n Administrative databases from the City of Philadelphia that track public shelter utilisation (n=44\u2009337) and AIDS case reporting (n=7749) were merged to identify rates and risk factors for co-occurring homelessness and AIDS.<\/jats:p>\n <\/jats:sec>\n \n DESIGN<\/jats:title>\n Multiple decrement life tables analyses were conducted, and logistic regression analyses used to identify risk factors associated with AIDS among the homeless, and homelessness among people with AIDS.<\/jats:p>\n <\/jats:sec>\n \n SETTING<\/jats:title>\n City of Philadelphia, Pennsylvania, USA.<\/jats:p>\n <\/jats:sec>\n \n MAIN RESULTS<\/jats:title>\n People admitted to public shelters had a three year rate of subsequent AIDS diagnosis of 1.8 per 100 person years; nine times the rate for the general population of Philadelphia. Logistic regression results show that substance abuse history (OR = 3.14), male gender (OR = 2.05), and a history of serious mental disorder (OR = 1.62) were significantly related to the risk for AIDS diagnosis among shelter users. Among people with AIDS, results show a three year rate of subsequent shelter admission of 6.9 per 100 person years, and a three year rate of prior shelter admission of 9%, three times the three year rate of shelter admission for the general population. Logistic regression results show that intravenous drug user history (OR = 3.14); no private insurance (OR = 2.93); black race (OR = 2.82); pulmonary or extra-pulmonary TB (OR = 1.43); and pneumocystis pneumonia (OR = 0.56) were all related to the risk for shelter admission.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Homelessness prevention programmes should target people with HIV risk factors, and HIV prevention programmes should be targeted to homeless persons, as these populations have significant intersection. Reasons and implications for this intersection are discussed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/jech.55.7.515","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:33:18Z","timestamp":1027751598000},"page":"515-520","source":"Crossref","is-referenced-by-count":97,"title":["The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilisation in Philadelphia"],"prefix":"10.1136","volume":"55","author":[{"given":"D P","family":"Culhane","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Gollub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Kuhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Shpaner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,7,1]]},"reference":[{"key":"2025100302201112000_55.7.515.1","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1001\/archinte.1990.00390210032009","article-title":"Human immunodeficiency virus infection among homeless men in a New York City shelter.","volume":"150","author":"Torres","year":"1990","journal-title":"Arch Intern Med"},{"key":"2025100302201112000_55.7.515.2","doi-asserted-by":"crossref","first-page":"568","DOI":"10.2105\/AJPH.83.4.568","article-title":"Prevalence of HIV infection among psychiatric patients in a New York City men's shelter.","volume":"83","author":"Susser","year":"1993","journal-title":"Am J Public Health"},{"key":"2025100302201112000_55.7.515.3","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1176\/ajp.150.1.47","article-title":"HIV seroprevalence among homeless patients admitted to a psychiatric inpatient unit.","volume":"150","author":"Empfield","year":"1993","journal-title":"Am J Psychiatry"},{"key":"2025100302201112000_55.7.515.4","unstructured":"Greer P Dickinson G Parra F (June 4\u20139, 1989) HIV seropositivity in a clinic for the homeless. The Fifth Annual International Conference on AIDS.."},{"key":"2025100302201112000_55.7.515.5","unstructured":"Zolopa A Vranizan K Meakin R (July 19\u201324, 1992) Tuberculosis and HIV infection in the homeless population of San Francisco, CA. The Eighth Annual International Conference on AIDS."},{"key":"2025100302201112000_55.7.515.6","unstructured":"Torres RA Mani S Martin M (June 4\u20139, 1989) Homelessness among hospitalized patients with AIDS-related complex in New York City. The Fifth International Conference on AIDS."},{"key":"2025100302201112000_55.7.515.7","unstructured":"Acquaviva K Culhane DP (1996) AIDS housing needs assessment: results from a consumer survey. (Office of Housing and Community Development, City of Philadelphia)."},{"key":"2025100302201112000_55.7.515.8","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.2105\/AJPH.89.7.1101","article-title":"Schizophrenia and major affective disorder among Medicaid recipients with HIV\/AIDS in New Jersey.","volume":"89","author":"Walkup","year":"1999","journal-title":"Am J Public Health"},{"key":"2025100302201112000_55.7.515.9","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/10511482.1994.9521155","article-title":"Public shelter admission rates in Philadelphia and New York City: The implications of turnover for sheltered population counts.","volume":"5","author":"Culhane","year":"1994","journal-title":"Housing Policy Debate"},{"key":"2025100302201112000_55.7.515.10","unstructured":"Culhane DP, Averyt J, Hadley TR. The treated prevalence of behavioral health disorders among adults admitted to the Philadelphia shelter system: Results from the integration of longitudinal data on behavioral health and shelter utilization. Rockville, MD: US DHHS, SAMHSA, Center for Mental Health Services (in press).."},{"key":"2025100302201112000_55.7.515.11","first-page":"23","article-title":"Applying cluster analysis to test a typology of homelessness by pattern of public shelter utilization: results from the analysis of administrative data.","volume":"17","author":"Kuhn","year":"1998","journal-title":"Am J Community Psychol"},{"key":"2025100302201112000_55.7.515.12","unstructured":"AIDS Activities Coordinating Office (1994) Quarterly report. (Philadelphia Department of Health, Philadelphia)."},{"key":"2025100302201112000_55.7.515.13","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1176\/ps.48.3.390","article-title":"The rate of public shelter admission among Medicaid-reimbursed users of behavioral health services.","volume":"48","author":"Culhane","year":"1997","journal-title":"Psychiatr Serv"},{"key":"2025100302201112000_55.7.515.14","first-page":"69","article-title":"Accuracy of diagnoses of schizophrenia in Medicaid Claims.","volume":"43","author":"Lurie","year":"1992","journal-title":"Hospital and Community Psychiatry"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech.55.7.515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T09:20:19Z","timestamp":1759483219000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech.55.7.515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,7,1]]},"references-count":14,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2001,7,1]]},"published-print":{"date-parts":[[2001,7,1]]}},"alternative-id":["10.1136\/jech.55.7.515"],"URL":"https:\/\/doi.org\/10.1136\/jech.55.7.515","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,7,1]]}}}