# 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

> **NIH NIH U01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $806,431

## Abstract

ABSTRACT
The US is currently on pace to fall short of achieving the goals set by the Ending the HIV Epidemic (EHE) initiative
launched by the Department of Health and Human Services in 2019. A growing body of research suggests that
the root causes of EHE's striking lack of progress are structural racism and social stratification that leads to
poverty. Housing instability — a lack of stable, secure, and adequate housing that results from poverty and
structural racism — is a major social determinant of health (SDOH). The Philadelphia Department of Health
(PDPH) estimates that 4,000 people with HIV (PWH) experience housing instability in Philadelphia. While the
National HIV/AIDS strategy specifically calls for approaches to address SDOH (including through the
development and scaling up of housing interventions), the vast majority of EHE efforts continue to focus on
facilitating healthcare access and uptake. 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
(~200 anticipated enrollments during the first several years). AAY includes (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. If the AAY screening period begins before this proposal's
full review by NIH, we have pilot funding from PDPH to collect baseline data. Since PDPH's lottery drawing is
necessitated by high anticipated demand (PDPH estimates there are 4,000 PWH in Philadelphia experiencing
housing instability) and limited initial availability (~200 available spots during the first few years), 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. This proposal is innovative in that we will capitalize on a unique opportunity to use rigorous causal and
implementation science methodology to evaluate the health and non-health effects of a population-level large-
scale housing intervention that addresses an important SDOH. This approach could significantly impact both
HIV- and non-HIV-related outcomes, such as viral suppression, ART adherence, engagement in care, substance
use, financial well-being, ho...

## Key facts

- **NIH application ID:** 11059423
- **Project number:** 1U01NR021556-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Aaron G Richterman
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $806,431
- **Award type:** 1
- **Project period:** 2024-09-23 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11059423

## Citation

> US National Institutes of Health, RePORTER application 11059423, 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 (1U01NR021556-01). Retrieved via AI Analytics 2026-06-13 from https://api.ai-analytics.org/grant/nih/11059423. Licensed CC0.

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