The prevalence of homelessness among injection drug users with and withoutHIV infection

Cross-sectional investigations of homelessness have many potential biases. Data from 2,452 individuals enrolled in a longitudinal cohort study of Balt imore, Maryland, residents recruited in 1988-1989 with a history of injecti on drug use were analyzed to identify the extent and determinants of homele ssness. Proportions having ever experienced homelessness were compared acro ss subgroups of injection drug users (IDUs) who were human immunodeficiency virus (HIV) negative, HIV positive, and I-IN seroconverting. Logistic regr ession identified independent predictors of homelessness. In the cohort, 1, 144 (46.7%) participants experienced homelessness during the course of the study. There were differences in prevalence of homelessness by serostatus: 42.4% (n = 621) of participants who remained HIV negative were ever homeles s, while 50.6% (n = 346) of HIV-infected individuals and 58.9% (n = 178) of those who seroconverted during the study were ever homeless (P < .001). Pa rticipants who consistently denied active injection drug use during follow- up were unlikely to experience homelessness (19%). independent predictors o f homelessness were male sex, HIV seroprevalence, and HN seroconversion. Fo llowing participants over time captures more experiences of homelessness th an cross-sectional studies and more accurately identifies risk characterist ics. Our data suggest that homelessness is a significant problem among IDUs , especially those with HIV/AIDS.