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At least 19 recordsLinked to original sources
PubMed1976

Friendship and disaffiliation among the skid row population.

Personal relationships of skid row men have been described in terms of disaffiliation and replacemtent of friends. Analysis of social relationships of Philadelphia skid row residents upheld the theory of replacement. There was, however, a decline in the number of friends reported after the age of 70, which generally coincided with 20 years residence in the area. The loss of relationships was more closely associated with length of residence in skid row than with age. Qualitative measures of personal relationships indicated no major association between sociability and length of residence in skid row but a small association with advancing age. The proportions of friendless men desiring either friends of casual acquaintances were not related to either age or length of residence. These findings fail to uphold the disaffiliation hypothesis of aging and run counter to Vesliard's postulate of loss of need for meaningful personal relationships with increased exposure to the life of an outcast.

Aged↗
PubMed1976

Use of coercion in the outpatient treatment of alcoholism.

Attendance patterns of voluntary patients at an alcoholism clinic were compared with those of persons convicted of drunken driving who were required to attend the clinic as a condition of probation. The attendance rate of the coerced patients was much superior to that of the voluntary patients.

Adult↗
PubMed1975

A behavioral intervention program for chronic public drunkenness offenders.

A reinforcement contingency management system for ten chronic public drunkenness offenders was evaluated for short-term effects. Chronic inebriates were provided with required goods and services through skid row community agencies contingent on their sobriety. Intoxication resulted in a five-day suspension of all goods and services. Excessive drinking behavior was assessed by direct observations of intoxication and by randomly administered breath alcohol analyses. As a result of this intervention, subjects substantially decreased their number of public drunkenness arrests and their alcohol consumption, and increased their number of hours employed. No such changes were observed in a control group that received services on a noncontingent basis. Longer-term research studies of one to two years rather than a few months would be required before any widespread use of this approach would be warranted.

Alcohol Drinking↗
PubMed2026

Smoke-Free Home Intervention in Permanent Supportive Housing: A Cluster Randomized Clinical Trial.

IMPORTANCE: Chronic diseases related to tobacco use and secondhand smoke exposure are the leading causes of death among formerly homeless adults living in permanent supportive housing (PSH) in the US. OBJECTIVE: To evaluate the efficacy of a brief, smoke-free home intervention in promoting voluntary smoke-free home adoption among PSH residents. DESIGN, SETTING, AND PARTICIPANTS: In this cluster randomized clinical trial, data collection occurred from January 11, 2022, to March 31, 2025. Participants were residents aged 18 years or older who smoked cigarettes at home in 40 multiunit PSH sites in the San Francisco Bay area, randomized to intervention or waiting list control clusters, and housing staff who worked at the study sites. INTERVENTION: Residents in intervention sites received one-on-one in-person coaching from research staff on adopting a smoke-free home; waiting list control site residents received no interventions during the study but were offered the intervention once the intervention group completed follow-up. Staff in both intervention and control sites received training on providing brief tobacco cessation coaching. MAIN OUTCOMES AND MEASURES: Primary outcomes were smoke-free home adoption for at least 90 days and 7-day carbon monoxide-verified point prevalence abstinence (PPA; expired carbon monoxide level ≤5 ppm) at 6 months. Secondary outcomes were any adoption (≥1 day) of a smoke-free home in the past 90 days among residents and changes in Smoking Knowledge, Attitudes, and Practices (S-KAP) scores among staff. RESULTS: The trial enrolled 400 residents (mean [SD] age, 54.5 [10.7] years; 251 [63.1%] male), 191 in the intervention and 209 in the control cluster. At 6 months, 13 residents (6.8%) in the intervention and 10 (4.8%) in the control group adopted a smoke-free home for at least 90 days (odds ratio [OR], 1.45; 95% CI, 0.69-3.07). Few residents achieved 7-day PPA, though more intervention residents (12 [6.3%]) achieved it compared with controls (2 [1.0%]) (OR, 6.94; 95% CI, 1.69-28.45). Intervention residents had greater odds than control residents of any smoke-free home adoption of at least 1 day (121 [63.4%] vs 77 [36.8%]; adjusted OR, 3.83 [95% CI, 2.63-5.57]). Among staff, mean (SD) S-KAP scores increased at 6 months vs baseline for beliefs (by 0.21 [0.55] points) and practices (by 0.24 [0.61] points) pertaining to providing cessation treatment. CONCLUSIONS AND RELEVANCE: In this cluster randomized clinical trial, the brief intervention did not result in a significant increase in smoke-free home adoption for at least 90 days, though more residents in the intervention than the control group attempted adoption for at least 1 day. These findings support the scalability of this approach to reduce smoking in PSH, but more intensive interventions may be needed to sustain intervention effects. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04855357.

Humans↗
PubMed2026

"Everybody thinks that it won't happen to them": A mixed-methods study of HIV prevention strategies among people experiencing homelessness who use drugs.

BACKGROUND: HIV disproportionately affects people experiencing homelessness, particularly those who use drugs. Although effective prevention strategies exist, uptake remains suboptimal in high-risk populations. Limited research has examined how this population engages with HIV prevention strategies and the contextual factors shaping behaviors. METHODS: We conducted a mixed-methods study of adults (≥18 years) experiencing homelessness with recent drug use, recruited from three Boston sites (Feb 2024-Jan 2025). Participants completed a survey assessing HIV prevention strategy uptake. A subsample completed in-depth interviews on factors influencing behavior. Guided by the Theoretical Domains Framework, we coded qualitative data and identified themes to help contextualize uptake. RESULTS: Among 196 participants, mean age was 48; 61% identified as male and 44% as non-Hispanic White. Forty-two percent reported condomless sex, and among those who had ever injected drugs (n = 123), 24% reported syringe sharing in the prior three months. Only 9% reported current PrEP use, and 12% had ever used HIV self-tests. Qualitative findings highlighted perceived control as a key facilitator, while low perceived HIV risk hindered uptake across strategies. Additional barriers varied by strategy and included partner dynamics and substance use affecting condom use, structural constraints affecting syringe use, and knowledge, stigma, and cost concerns affecting PrEP and self-testing. CONCLUSION: In this cohort of people experiencing homelessness who use drugs, HIV prevention strategy uptake was suboptimal, with particularly low PrEP and HIV self-testing use. Qualitative findings suggest that interventions to promote HIV prevention strategy uptake in this population should leverage perceived control, address perceived risk, and target strategy-specific interpersonal and structural barriers.

Humans↗
PubMed2026

Walking Together: A Cross-Cultural Study of the Relationship Between Religiosity and Substance Use Disorder.

The literature suggests that religiosity is a protective factor for substance use. However, individuals with substance use disorder (SUD) may actively cultivate their religiosity during substance use. This qualitative study analyzed the perceptions and meanings homeless people attribute to their substance use trajectories and religiosity, as well as the potential connections between these two themes. The analysis was conducted based on the content analysis technique proposed by Bardin. A total of 40 semi-structured interviews were conducted with 20 Brazilian and 20 Portuguese participants. The present study found that religiosity can play a role in the substance use trajectory and the development of SUD by offering a subjective sense of protection, serving as a marker for the need for change, or providing relief from the suffering associated with SUD. We discuss how homeless people with SUD experience religiosity and how religious aspects traditionally seen as protective in the literature, such as church attendance, may paradoxically become risk factors for these socially vulnerable populations.

Humans↗
PubMed2026

First year of ongoing invasive Haemophilus influenzae type b outbreak among middle-aged people who use drugs and people who experience homelessness in Hamburg, Germany, September 2024 to August 2025.

We report an ongoing outbreak of invasive Haemophilus influenzae type b (Hib) disease among people who use drugs (PWUD) and people experiencing homelessness (PEH) in Hamburg, Germany. Between 1 September 2024 and 31 August 2025, 20 adult Hib cases were reported. The cases were either residents of Hamburg (16/20) or stayed in Hamburg during the exposure period (4/20). Whole genome sequencing identified a link between 18 cases (median age 50 years (range 26-77); six female, 12 male, three died). An epidemiological link (i.e. drug consumption in the open drug scene) could be established for 15 of the 18 cases. Control measures included post-exposure chemoprophylaxis for close contacts (n = 4), vaccination offers (n = 69 doses administered by 31 August 2025) and an information campaign targeting PWUD, PEH and staff members of addiction support centres. We describe the first Hib outbreak among adults in Europe and document drug use and homelessness as suspected risk factors. Based on these findings, national vaccination recommendations issued by the Standing Committee on Vaccination in Germany (STIKO) were updated to include vaccination and post-exposure prophylaxis recommendations in outbreak settings for PWUD and PEH. Control measures are currently being evaluated and expanded.

Humans↗