On behalf of the teams in the Offices of Special Needs Assistance Programs (SNAPS) and HIV/AIDS Housing (OHH), we wanted to take a moment to commemorate World AIDS Day 2017, and highlight how critical safe, stable housing is for the health and well-being of persons living with HIV/AIDS (PLWHA). Countries around the globe observe World AIDS Day annually on December 1. It provides an opportunity for all of us to come together in the fight against HIV/AIDS, stand in solidarity with PLWHA, and remember those who have died.
Access to safe, stable housing has been a major issue facing PLWHA since the beginning of the epidemic. It is estimated that approximately half of the 1.2 million PLWHA in the U.S. will experience homelessness or housing instability at some point following their diagnosis. Economic disadvantages, episodes of poor health, and co-occurring substance use and mental health needs often make it difficult for many PLWHA to secure or maintain housing. HIV/AIDS-related stigma and discrimination add additional barriers to accessing and maintaining housing.
The Centers for Disease Control and Prevention (CDC) reported earlier this week on HIV testing in the U.S. According to this report, nearly 40,000 Americans received an HIV diagnosis in 2015, and 1 out of 2 of them had already been living with HIV for more than 3 years before being diagnosed. 1 out of 4 had been living with the virus for 7 years or longer. For Americans experiencing homelessness and poverty, ensuring access to HIV testing and services is critical in ending the HIV epidemic in our country.
According to the CDC, black, gay, and bisexual men are more impacted by HIV than any other group in the U.S. Stigma, homophobia, and discrimination put gay and bisexual men at risk for many physical ailments and mental health issues, and can affect whether they seek and receive health services, including HIV testing, treatment, and other prevention services. In addition, transgender women are at high risk for HIV. Per the U.S. Transgender Survey, 19.0% of black transgender women were living with HIV in 2015, 60 times the rate of HIV infection in the general U.S. population (0.3%). Many transgender people face stigma, discrimination, social rejection, and exclusion that prevents them from accessing health care, education, employment, and housing. These factors affect health and well-being and increase the risk of acquiring HIV.
We know that homelessness and housing instability are directly linked to poor health outcomes for PLWHA. PLWHA who lack stable housing are more likely to delay or drop out of HIV care and less likely to receive HIV medications than PLWHA who are stably housed. For homeless and unstably housed PLWHA, evidence suggests that housing assistance is an effective HIV health and public health intervention. Over time, receipt of housing assistance has been found to be among the strongest predictors of accessing and maintaining HIV medical care. Housing interventions improve stability and connection to care for PLWHA by providing an essential foundation for participation in lifesaving HIV care and treatment. When PLWHA participate in medical care and take medications as prescribed, they can achieve viral suppression, meaning the amount of HIV virus in the blood is reduced to a very low level. By achieving viral suppression, PLWHA can stay healthy, live longer, and effectively eliminate the risk of sexually transmitting HIV to a partner.
All levels of government, as well as private entities, play an important role in preventing and ending homelessness for PLWHA, and our partnerships help to maximize all available resources. We encourage providers receiving funding from various HUD programs (e.g. Housing Opportunities for Persons With AIDS, Continuum of Care, and Emergency Solutions Grants) and non-HUD programs to continue strengthening local partnerships to better prevent and end homelessness for PLWHA in their communities. Local partners should work to better identify homeless and unstably housed PLWHA and link them to appropriate housing resources, medical care, and other services.
SNAPS and OHH will continue to identify opportunities for cross-program messaging, guidance, and technical assistance as we stay focused on our core mission of ensuring that those who are some of the most vulnerable in our nation – individuals and families experiencing homelessness and those living with HIV/AIDS – are served by programs with the best outcomes and highest standards of service.
Director, Office of Special Needs Assistance Programs
Director, Office of HIV/AIDS Housing
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