366P
POOR HEALTH OUTCOMES AND MORE INTENSIVE DRUG USE AMONG RESIDENTS OF UNREGULATED SINGLE ROOM OCCUPANCY HOTELS
K Shannon1, T Kerr1, C Lai1, T Ishida1, A Palepu2, E Wood3, M Tyndall2
¹British Columbia Centre for Excellence in HIV/AIDS; 2British Columbia Centre for Excellence in HIV/AIDS/Faculty of Medicine, University of British Columbia; 3British Columbia Centre for Excellence in HIV/AIDS/Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia
Introduction: The main outcome of poverty and homelessness in Vancouver's downtown eastside (DTES) has been the propagation of unregulated single room occupancy (SRO) hotels. These SRO units represent the most basic shelter provided for low-income individuals. While homelessness and marginalized housing in general, have been identified as environments that facilitate HIV risk behaviours, little attention has been paid to the specific context of living in unregulated SRO hotels.
Methods: This analysis was undertaken to describe the characteristics of individuals living in SROs among a population-based cohort (CHASE) and to explore associations with drug use and health outcome measures. In total, 2574 participants were eligible for the present analysis. Univariate analysis was used to determine associations with SROs and logistic regression modeling was conducted to adjust for confounding.
Results: Of the total, 1813 reported living in SROs and 755 reported living in stable housing. The median age was 42 years (IQ range: 36–49 years). Among residents of SROs, 1108 (61%) had lived in the current SRO for less than one year (median number of moves/ year =5). Variables found to be independently associated with SROs included HIV infection (Adjusted Odds Ratio, 1.6, 95% CI: 1.2–2.0), injection drug use (aOR, 2.0, 95% CI; 1.6–2.5), incarceration (aOR, 2.1, 95% CI: 1.7–2.4), ER use (aOR, 1.7, 95% CI:1.3–2.2), and being physically assaulted (aOR, 2.3, 95% CI: 1.7–2.8).
Conclusions: Living in SRO hotels was associated with more intensive injection drug use and an array of poor health outcomes, including HIV infection. Given previously observed risk behaviours among homeless populations, these findings highlight the urgent need to address social living conditions of the majority of DTES residents. Despite enhanced syringe exchange programs, primary health clinics, social services and other harm reduction initiatives, impoverished living conditions continue to overwhelm efforts to improve the health status of this highly marginalized population.