Our Projects

A Type 1 Hybrid Effectiveness-Implementation Evaluation of a City-Level Transitional Housing Program’s Effects on Health, Economic, and Psychologic Outcomes Among People with HIV
Philadelphia, PA

Housing instability — a lack of stable, secure, and adequate housing that results from poverty and structural racism — is a major social determinant of health. The Philadelphia Department of Public Health (PDPH) estimates that 4,000 people with HIV (PWH) experience housing instability in Philadelphia. There have been few rigorous evaluations of housing interventions for PWH, and even fewer during the modern era of universal treatment for HIV. In close partnership with the PDPH, we will rigorously evaluate a potentially transformative city-level transitional housing program for PWH experiencing housing instability (“Arms Around You” or AAY), leveraging lottery drawings from a waitlist to estimate causal effects. The program will be implemented by PDPH in 2024 and scaled up in the coming years. AAYincludes(1) intensive housing counseling, (2) housing medical case management, and (3) full rent payment support for 48 months (or longer if needed). We will use mixed methods to collect quantitative (survey data, pharmacy refill data, and PDPH surveillance/program data) and qualitative (key stakeholder interviews) data. Since PDPH’s lottery drawing is necessitated by high anticipated demand and limited initial availability, we will be able to estimate the long-term effects of the program on health, economic, and psychological outcomes. In addition to studying mechanisms through which housing interventions affect health outcomes, we will use implementation science methods to assess program acceptability, reach, sustainment, and costs to inform scalability to other cities.