Housing as HIV Prevention
As many as 60% of all HIV positive people have experienced homelessness or unstable housing (such as staying on a friend's couch, where a person could be kicked out at any time) in their lifetimes, according to research by Angela Aidala, Ph.D. of the Mailman School of Public Health at Columbia University. But often, even when organizations or governments provide housing as a part of HIV services, the issue is talked about in a way that blames individuals for "risky behavior" and assumes that if someone is dealing with both housing problems and HIV, these two challenges are a result of being a "risky person."
For 20 years, AIDS housing activists have known that housing challenges are often beyond the control of an individual because lack of stable, adequate housing affects whole communities and is rooted in racism and poverty. The research of Mindy Fullilove, also at Mailman, has shown that destruction of urban neighborhoods uproots whole communities of people and makes them vulnerable to homelessness, drug use, and HIV.
Rodrick Wallace, an epidemiologist at the New York State Psychiatric Institute, also points to the forced displacement of Black neighborhoods, whether through urban renewal programs, redlining (when banks refuse to lend money to African Americans to buy homes), eminent domain (a legal process by which houses are taken for city or commercial use of the land), gentrification (when residents are priced out of their neighborhoods by an influx of wealthier residents), or disasters like Hurricane Katrina (due to neglect of infrastructure), and the Bronx fires in the 1970s (due to the closing of firehouses). "Health disparities in the Black community can be traced to a 70-year course of serial forced displacement," Wallace says, and he offers a dire warning for New York City. "Gentrification is driving African Americans from Harlem, the South Bronx and Bedford-Stuyvesant [Brooklyn], which will create a ring of refugee camps around an alabaster white city. Multi-drug resistant HIV will be allowed to grow in these communities over time before spreading to the rest of the world."
Poor communities are experiencing forced displacement in cities around the world, with even worse implications in places like South Africa, where the HIV rate is already extremely high. But people living in shacks around the cities of South Africa are resisting forced evictions, and people living with HIV in New York City are demanding housing -- not just for their own survival, but also as a prevention tool. Activists at Housing Works, Gay Men's Health Crisis (GMHC), and the New York City AIDS Housing Network (NYCAHN) are leading a campaign to force New York City to provide housing to all people living with HIV by expanding the city's unique policy that guarantees housing only to people living with an AIDS diagnosis.
"One of the single biggest ways to prevent HIV by reducing risk behavior is to provide stability in housing," says Charles King, president and CEO of Housing Works. "As long as you have chronic homelessness, people will be involved in drug activity that's related to their homelessness and sex trade that's related to their homelessness. Whether you're HIV positive or negative, homelessness increases the risk of HIV transmission. The more people are forced to engage in survival activities, the greater the risk."
Alan Perez, coordinator of the Legislative Action Group at GMHC, agrees and emphasizes how unstable housing puts people at risk. "We have clients who have to sell their bodies just to stay where they're at," he says.
With organizing help from Housing Works and the National AIDS Housing Coalition (NAHC), researchers have come together with new data showing that housing is integral to HIV treatment, care and prevention. And activists are using the research as tools in their advocacy. This collaboration between activists and researchers is further strengthened by collaboration between AIDS housing activists and housing justice activists, people who fight to end homelessness and gentrification in cities around the world. This issue of Solidarity Project explores some of this inspiring work.
This article was provided by Community HIV/AIDS Mobilization Project. It is a part of the publication Solidarity Project.