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Homeless and inadequately housed clients have a lower rate of adhering to anti-retroviral therapy (ART) medications. Advances in ART have lead to a longer life expectancy for clients living wth HIV and AIDS, however clients need to be adhering to medications to benefit.

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When clients are homeless or inadequately housed it makes it difficult to rememberer to attend medical appointments, pick up prescriptions and take medications as prescribed as their basic need for shelter have not been met. Also, clients who are unstably housed may have poor hygiene and a lack of nutrition and rest. Medication adherence is probably not a high priority for these clients.

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The purpose of this study would be to establish if there is a correlation with medication adherence and being stably housed. If evidence is found to have a correlation this data can be used to assist in receiving grants and federal funds to developing more housing for HIV/ AIDS homeless clients.

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Does being stably housed lead to an increase in anti-retroviral medication adherence?

Hypotheses 1- Clients who are stably housed have a higher medication adherence than clients who are not stably housed.

Hypotheses 2- There is no difference in medication adherence between homeless clients and clients who are stably housed.

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The population for this study would be 300 clients from the health home department who are diagnosed with HIV/ AIDS. Out of the 300 clients 175 have self reported being stably housed and 125 are self reported as homeless/ unstably housed.

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A nonexperimental, cross-sectional research will be used to conduct this study.

Independent variable 1- stably housed
Independent variable 2- homelessness
Dependent variable- Anti-retroviral medication adherence

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Data for this study will consist of a 5 question survey using yes and no answers. It will be administered to clients in person either in their home or in the office for higher percentage of completion. Clients will fill out the survey only once throughout the research.

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A threat to external validity is population validity. Health home clients who the sample population was derived from have co morbid diagnosis either mental health or another chronic medical condition. The results from this study might not be applicable to the general population of those living with HIV/AIDS therefor the result might not be able to be generalized.

Temporal validity is also a threat to external validity. It will be unknown if the results of the research is accurate throughout the persons life. For example a client who is housed might be adhering to medications at that moment the survey was administered however might not be adhering to medications in the future for various reasons. There is no way to track adherence or lack of adherence for a substantial amount of time.

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Differential selection is a threat to internal validity. Differential validity is "selecting participants who have different characteristics for the various treatment groups" (Johnson & Christensen, 2013, p. 289). It may be unknown if individual characteristic play a role among clients who choose to adhere to medications and those who do not regardless of housing situation.

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In the article Predictors of Self-Reported Adherence to Antiretroviral Medication in a Multisite Study of Ethnic and Racial Minority HIV-Positive Youth (2016), the authors focused on identifying predictors for high adherence for ART medication amongst 16-24 year olds.  There was no manipulation of independent variable, the sample were 956 participants in a trial for medication adherence.  The data was extrapolated from the clients medical records and self survey.

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Johnson, R. B., & Christensen, L. (2013). Educational research: Quantitative, qualitative, and mixed approaches (5th ed.). Thousand Oaks, CA: SAGE Publications.

MacDonell, K.K., Jacques-Tiura, A.J.,  Naar, S. &  Fernandez, M.I. (2016). Predictors of Self-Reported Adherence to
Antiretroviral Medication in a Multisite Study of Ethnic and Racial Minority HIV-Positive Youth. Journal of Pediatric Psychology, 41(4), pp. 419–428. doi: 10.1093/jpepsy/jsv097