Moving from Fact to Policy: Housing is HIV Prevention and Health Care

Shubert, Virginia; Bernstine, N.

doi:10.1007/s10461-007-9305-9

Cited by 38 publications

(29 citation statements)

References 35 publications

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“…Follow-up rates in this study were high and adherence was comparable to that for HIV intervention trials with other populations [16,35], indicating the ability of homeless and unstably housed persons to be maintained in communitybased medical care for HIV and the potential value of linking this care to housing services. Proactive strategies for providing HIV care to homeless and other disenfranchised PLWHA have the potential to benefit individual and public health [6,7,36].…”

Section: Discussionmentioning

confidence: 99%

Randomized Trial of the Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living with HIV

Wolitski¹,

Kidder²,

Pals³

et al. 2009

AIDS Behav

189

197

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Homelessness affects HIV risk and health, but little is known about the longitudinal effects of rental assistance on the housing status and health of homeless and unstably housed people living with HIV/AIDS. Homeless/unstably housed people living with HIV/AIDS (N = 630) were randomly assigned to immediate Housing Opportunities for People with AIDS (HOPWA) rental assistance or customary care. Self-reported data, CD4, and HIV viral load were collected at baseline, 6, 12, and 18 months. Results showed that housing status improved in both groups, with greater improvement occurring in the treatment group. At 18 months, 51% of the comparison group had their own housing, limiting statistical power. Intent-to-treat analyses demonstrated significant reductions in medical care utilization and improvements in self-reported physical and mental health; significant differential change benefiting the treatment group was observed for depression and perceived stress. Significant differences between homeless and stably housed participants were found in as-treated analyses for health care utilization, mental health, and physical health. HOPWA rental assistance improves housing status and, in some cases, health outcomes of homeless and unstably housed people living with HIV/AIDS.

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Section: Discussionmentioning

confidence: 99%

Randomized Trial of the Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living with HIV

Wolitski¹,

Kidder²,

Pals³

et al. 2009

AIDS Behav

189

197

View full text Add to dashboard Cite

show abstract

“…Homeless persons are at increased risk of HIV infection and homelessness negatively affects the health of PLWHA (Aidala and Sumartojo 2007;Kidder et al in press;2007a;Shubert and Bernstine 2007;Wolitski et al 2007). Homeless and unstably housed PLWHA may be more likely to experience HIV-related stigma, but little is known about how different subgroups of PLWHA experience HIV stigma.…”

Section: Introductionmentioning

confidence: 99%

“…Homeless and unstably housed PLWHA represent a vulnerable population that has been shown to be at increased risk for multiple health threats including substance abuse, mental illness, violence, poor access and adherence to HIV medical care, and high-risk sexual practices Aidala and Sumartojo 2007;Eastwood and Birnbaum 2007;Henny et al 2007;Kidder et al 2007a;Leaver et al 2007;Shubert and Bernstine 2007;Wolitski et al 2007). As such, this population may be particularly vulnerable to HIV-related stigma and its negative effects.…”

Section: Introductionmentioning

confidence: 99%

The Effects of HIV Stigma on Health, Disclosure of HIV Status, and Risk Behavior of Homeless and Unstably Housed Persons Living with HIV

et al. 2008

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HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.

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“…The specific health vulnerabilities of people with HIV, such as compromised immunity, health co-morbidities, treatment adherence, and illness and treatment side effects, can put those without stable housing at greater risk of poorer health. Study findings on housing instability and health for people with HIV indicate that those who are unstably housed experience worse mental and physical health outcomes, have lower CD4 counts, have higher viral loads, suffer higher rates of mortality, are more likely to be admitted to a hospital or to emergency care and are less likely to be on antiretroviral therapy (ART) or to regularly adhere to ART (Leaver et al 2007;Kidder et al 2007;Rourke et al 2012;Shubert and Bernstine 2007).…”

Section: Healthy Housing and Hivmentioning

confidence: 99%

Not Just “A Roof over Your Head”: The Meaning of Healthy Housing for People Living with HIV

Chambers

Greene

Watson

et al. 2014

Housing, Theory and Society

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The literature has identified housing as a fundamental unmet need for people living with HIV; yet there has been little qualitative evidence exploring housing and HIV, particularly from a Canadian context. This paper focuses on our qualitative analyses of the housing experiences of 48 HIV-positive people living in Ontario. Findings from our interviews illustrate healthy housing as a dynamic interconnection between health, housing and other social factors that are influential to the health and well-being of people with HIV. Four salient themes have emerged from our qualitative findings: the interplay between healthy housing and economic security; the relationship between HIV, health and housing precariousness; the interconnection between housing, HIV, safety, stigma, social isolation and social exclusion; and the meaning of healthy housing for people living with HIV. These findings reemphasize the importance of housing policies that consider housing as more than just a roof over one's head, but also as something that supports the physical, mental, emotional and social well-being of people living with HIV. This article is dedicated to the memory of LaVerne Monette, co-investigator with the Positive Spaces, Healthy Places (PSHP) research project, who passed away on December 1, 2010. Responsible for the Aboriginal arm of the study, she played a key role in developing the larger study. She brought to our team her life experiences as an Aboriginal woman and her passion to help Aboriginal people living with and at risk of HIV. She understood the critical role of housing in health and quality of life, and was a strong advocate for research to identify the housing needs of Aboriginal people in Ontario and for policy change that will lead to safe, stable housing for all.

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Moving from Fact to Policy: Housing is HIV Prevention and Health Care

Cited by 38 publications

References 35 publications

Randomized Trial of the Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living with HIV

Randomized Trial of the Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living with HIV

The Effects of HIV Stigma on Health, Disclosure of HIV Status, and Risk Behavior of Homeless and Unstably Housed Persons Living with HIV

Not Just “A Roof over Your Head”: The Meaning of Healthy Housing for People Living with HIV

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