This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Association With Mycobacterium tuberculosis Infection

Ramon A. Torres, MD; Sridhar Mani, MD; Jeffrey Altholz, MD; Philip W. Brickner, MD

Arch Intern Med. 1990;150(10):2030-2036.

Abstract
• The human immunodeficiency virus (HIV) seroprevalence among a selected sample of 169 high-risk homeless men residing in a congregate shelter in New York City, NY, was 62%. Seropositivity for HIV correlated significantly with intravenous drug use (odds ratio, 3.3; 95% confidence interval, 1.4 to 4.4) and active tuberculosis (odds ratio, 7.0; 95% confidence interval, 3.4 to 13.5). Most cases of active tuberculosis were among homeless men with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex; and significant CD4 lymphocyte depletion was associated with active tuberculosis. Total time homeless correlated positively with active and latent tuberculosis infection. Compliance rates with return for HIV antibody test results, medications, and follow-up visits were 70%, suggesting a significant degree of knowledge, awareness, and personal concern regarding HIV infection among homeless men; yet 28% of homeless intravenous drug users continue active drug injection, despite HIV infection. Cohabitation in overcrowded congregate dormitories creates a risk of airborne transmission of tuberculosis, which is a common reactivation infection in HIV-seropositive homeless men. Medically appropriate housing should be provided to such homeless persons, and expanded HIV antibody testing, counseling, and medical services on site should be offered to residents of shelters.

(Arch Intern Med. 1990;150:2030-2036)

Author Affiliations
From the Departments of Medicine and Community Medicine, St Vincent's Hospital and Medical Center of New York (NY) (Drs Torres, Altholz, and Brickner), and Mt Sinai Hospital and Medical Center of New York (Dr Mani).

Footnotes
Accepted for publication April 30,1990.

Read in part before the Fifth International Conference on AIDS, Montreal, Quebec, June 5,1989.

Reprint requests to Departments of Medicine and Community Medicine, St Vincent's Hospital and Medical Center of New York, 153 W 11th St, New York, NY 10011 (Dr Torres).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Health Status, Health Care Use, Medication Use, and Medication Adherence Among Homeless and Housed People Living With HIV/AIDS
Kidder et al.
AJPH 2007;97:2238-2245.
ABSTRACT | FULL TEXT  

Strain-Specific Differences in Two Large Mycobacterium tuberculosis Genotype Clusters in Isolates Collected from Homeless Patients in New York City from 2001 to 2004.
Macaraig et al.
J. Clin. Microbiol. 2006;44:2890-2896.
ABSTRACT | FULL TEXT  

Revolving Doors: Imprisonment Among the Homeless and Marginally Housed Population
Kushel et al.
AJPH 2005;95:1747-1752.
ABSTRACT | FULL TEXT  

Treatment Preferences for Resuscitation and Critical Care Among Homeless Persons
Norris et al.
Chest 2005;127:2180-2187.
ABSTRACT | FULL TEXT  

HIV Seroprevalence Among Homeless and Marginally Housed Adults in San Francisco
Robertson et al.
AJPH 2004;94:1207-1217.
ABSTRACT | FULL TEXT  

Strategies to Decrease Tuberculosis in US Homeless Populations: A Computer Simulation Model
Brewer et al.
JAMA 2001;286:834-842.
ABSTRACT | FULL TEXT  

Mortality Among Men Using Homeless Shelters in Toronto, Ontario
Hwang
JAMA 2000;283:2152-2157.
ABSTRACT | FULL TEXT  

Hepatitis B virus infection among street youths in Montreal
Roy et al.
CMAJ 1999;161:689-693.
ABSTRACT | FULL TEXT  

Risk Factors for Death in Homeless Adults in Boston
Hwang et al.
Arch Intern Med 1998;158:1454-1460.
ABSTRACT | FULL TEXT  

Patterns of Tuberculosis Transmission in Central Los Angeles
Barnes et al.
JAMA 1997;278:1159-1163.
ABSTRACT  

Tuberculosis Prophylaxis in the Homeless: A Trial to Improve Adherence to Referral
Pilote et al.
Arch Intern Med 1996;156:161-165.
ABSTRACT  

Tuberculosis in the Homeless
Barclay et al.
Arch Fam Med 1995;4:541-546.
ABSTRACT  

Survival and Disease Progression According to Gender of Patients With HIV Infection: The Terry Beirn Community Programs for Clinical Research on AIDS
Melnick et al.
JAMA 1994;272:1915-1921.
ABSTRACT  

HIV and Tuberculosis Infection in San Francisco's Homeless Adults: Prevalence and Risk Factors in a Representative Sample
Zolopa et al.
JAMA 1994;272:455-461.
ABSTRACT  

Mortality in a Cohort of Homeless Adults in Philadelphia
Hibbs et al.
NEJM 1994;331:304-309.
ABSTRACT | FULL TEXT  

A Cohort Study of Drug Users' Compliance With Zidovudine Treatment
Broers et al.
Arch Intern Med 1994;154:1121-1127.
ABSTRACT  

Tuberculosis and AIDS: Epidemiologic, Clinical, and Social Dimensions
Selwyn
J Law Med Ethics 1993;21:279-288.
 

Homelessness and TB: A Study in Failure
Brudney
J Law Med Ethics 1993;21:360-367.
 

A Leap of Faith: What Can We Do To Curtail Intrainstitutional Transmission of Tuberculosis?
Iseman
ANN INTERN MED 1992;117:251-253.
ABSTRACT  

Tuberculosis Among Homeless Shelter Residents
JAMA 1992;267:483-484.