Housing, Health & HIV

Affordable housing has been a hot topic in Calgary over the last decade. The lack of affordable housing options in our relatively affluent city gets a lot of play in the media – and for good reason. Housing impacts a persons overall health and wellbeing. For someone living with HIV, stable housing is especially important.

Stable housing is "essential to accessing medical care, maintaining HIV and mental health treatment adherence and ensuring the prevention of HIV transmission."1 In the 2008 Calgary Coalition on HIV/AIDS (CCHA) housing study, individuals living with HIV reported that their health and financial issues had contributed to housing problems. Hospitalization, mental health issues, and a lack of income were just a few contributing factors to housing instability, eviction, and for some, homelessness.1

The Impact
There are many negative effects experienced by people living with HIV/AIDS (PLWHA) who are living in unstable housing conditions.

The CCHA study found that:
- Over half of respondents experienced increased stress
- 33% reported poor nutrition and poor personal hygiene
- 27% experienced illness
- 25% reported inadequate clothing (i.e. winter coats)
- 21% reported that they had experienced homelessness.1

Homeless and/or unstably housed PLWHA are also "more likely to have lower CD4 counts, higher viral loads, and higher mortality and are less likely to initiate or adhere to anti-retroviral medication regimens or access health care and social services."2

Stable housing can also have an impact on HIV prevention. The prevalence of HIV infection has been shown to be three to nine times higher among persons with an unstable housing situation compared to persons with stable and adequate housing.3

Although PLWHA may develop coping strategies to deal with unstable housing conditions (e.g. reducing expenses, living with roommates, borrowing money), “many of these strategies also create a negative impact by compounding debt loads, alienating social support networks, decreasing personal security through co-living arrangements, and compromising access to the basic needs necessary to maintain adequate health."1

Homelessness
For those people who aren’t able to access affordable housing, homelessness can quickly become a reality. "PLWHA who are experiencing homelessness in Canada are 2.5 times more likely to need medical assistance than those living in supported housing."4 For those living in a shelter environment, the high density of people and poor conditions can lead to increased risk of catching a cold, flu, or opportunistic infections.5

The need
PLWHA have identified "[b]asic needs including affordable, safe housing, nutritional food, and clothing" as "missing from the existing service spectrum in Alberta"; according to a 2006 environmental scan of services.6 A continuum of appropriate housing options is desperately needed in Calgary for all low-income earners, especially those with complicating factors such as HIV.


References
1. AIDS Calgary, The SHARP Foundation, & Mazonde, Josephine. HIV/AIDS and Housing Study. Prepared for the Calgary Coalition on HIV/AIDS. June 2008.
2. Canadian AIDS Society. “Bring Me Home”: The Canadian AIDS Society’s Position. May 2009. Retrieved December 7, 2010.
3. Aidala, A., “Homeless, Housing Instability and Housing Problems among Persons Living with HIV/AIDS,” NAHC Research Summit Presentation, 2005.
4. World Health Organization. Health Impact Assessment: The Determinants of Health. Retrieved December 7, 2010.
5. Rooftops Canada, Ontario HIV Treatment Network, & Positive Spaces Healthy Places. HIV, AIDS and Housing Issues. Prepared for the Interagency Coalition on AIDS and Development. Retrieved December 7,
6. AIDS Calgary & Barr, Valerie. An Environmental Scan of Services and Supports for People Living with HIV in Alberta. Prepared for the Alberta Community Council on HIV. June 16, 2006