AIDS Action Committee’s Blog

At AIDS Action, I let people know about HIV treatment advances and new approaches to prevent the spread of the virus. As exciting as these developments can be, it’s also essential to recognize the critical importance of support services for persons living with HIV.

There is extensive evidence that a person’s housing status – whether stably housed or homeless – has a huge impact on their health. The latest addition to this growing body of research is a special supplement to this month’s AIDS and Behavior journal. The supplement contains 18 peer-reviewed articles focusing on the relationship between housing status and a range of HIV-related health outcomes.

Several of these studies found that having stable housing reduces the likelihood that persons will engage in behaviors – such as sharing needles, having unprotected sex, or exchanging sex for drugs – that place them at high risk for becoming infected with HIV or transmitting the virus to others.

A group of Canadian researchers reviewed nearly 30 studies evaluating the effects of housing on health-related outcomes. These studies showed that, in addition to reducing risk behavior, stable housing helps HIV+ persons:

• Enter medical care and remain in care
• Access social services, including mental health and substance use programs
• Take their medications more consistently (better adherence)

Researchers in Chicago and San Francisco have found that programs providing stable housing for chronically homeless persons significantly reduce the number of emergency room visits and hospitalizations, as well as the length of time people spend in hospitals or nursing homes.

Taken together, these studies support the contention that housing itself independently reduces the risk of acquiring or transmitting HIV infection and improves the health of persons living with HIV.

“The findings reported here suggest that the condition of homelessness, and not simply traits of homeless individuals, influences risk behaviors and health care utilization,” according to Dr. Angela Aidala of the Columbia University Mailman School of Public Health. “This points to housing as a strategic target for intervention – a potentially exciting new tool to end the AIDS epidemic in America.”

As someone who has lived a relatively sheltered life, I always viewed homelessness as a problem that was addressed by legislators and officials. It was a problem that never seemed to affect me personally. It had to do with money and resources, and not with me.

And then I went to hear speakers from Youth on Fire, a program that works with homeless youth. Listening to these young people talk about their lives, I was shocked by how like me they were. They were people. They were my peers.

Shunned by a society that has no system of social support in place for them, kids are being placed in danger. My generation is in danger. These people, by virtue of being homeless, are three times more likely to have any type of chronic disease, including HIV/AIDS, than are those who are not homeless (http://www.nationalhomeless.org/publications/facts/HIV.pdf).

What’s worse is the cycle: those who are homeless are at high risk for HIV/AIDS and those who are HIV+ are at high risk for becoming homeless. Without social supports in place to stop this cycle, future patterns are, unfortunately, easy to predict. There is clearly a place within this issue for the legislators, but they cannot be alone. We need a system of people caring about people, not just of laws. It is time for us as a country to care about each other and stop detrimental patterns before they grow beyond our control.

Youth on Fire (Y.O.F.), a program of Cambridge Cares About AIDS, is a drop-in center for homeless and street-involved youth in Cambridge, MA. Through Y.O.F.’s Speaker’s Bureau, members share their experiences and perspectives as well as  provide advice to youth providers and students in the hopes of improving the services offered to high risk youth in the Boston area.