Housing status and HIV risk

New studies show that there is a demonstrable correlation between a person's housing status and his or her likelihood of transmitting or getting HIV.

The groundbreaking research from the Centers for Disease Control (CDC) and others has been reported in a special issue of the journal AIDS and Behavior¹.

According to researchers from the CDC, homelessness and unstable housing “increase the risk of HIV acquisition and transmission and adversely affect the health of people living with HIV.” The findings prompted the researchers to issue a call to action that “homelessness be treated as a major public health issue confronting the United States.”

The first publication of its kind, this special issue of AIDS and Behavior includes 18 peer-reviewed articles on the relationship of housing status and HIV risk and health outcomes, including a policy perspective from former HUD Secretary Henry Cisneros. Research studies reported in the issue show that:

• Homeless or unstably housed persons were two to six times more likely to “have recently used hard drugs, shared needles or exchanged sex” than similar low-income persons who were stably housed.
• Receipt of housing assistance enabled homeless persons with substance use and mental health problems to achieve stability over time and to cease or reduce both drug related and sexual risk behaviors.
• Over a 12-year period, housing status and receipt of housing assistance consistently predicted entry and retention in HIV medical care, regardless of demographics, drug use, health and mental health status, or receipt of other services.

These and other findings reported in the special issue add to the growing evidence that housing itself independently reduces risk of HIV infection and improves the health of persons living with HIV. This evidence challenges the prevailing “risky person” model for understanding the co-occurrence of homelessness, HIV/AIDS and poor health outcomes.

“The findings reported here suggest that the condition of homelessness, and not simply traits of homeless individuals, influences risk behaviors and health care utilization,” says Housing and HIV/AIDS Special Editor 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.”