Housing as Healthcare
Abstract Format : The AIDS Resource Foundation for Children is the lead of the New Jersey HIV/AIDS Housing Collaborative. The goal of the Collaborative is that no person living with HIV/AIDS experience homelessness, not even for one night. We unite community organizations and scattered site housing partners throughout the state into a Pipeline with trained Ambassadors at each location to maximize resources and create shared language for best practices. Our ultimate goal is to achieve zero new infections in the coming year. We will share our research, findings, and best practices as the lead of a statewide Housing as Healthcare intervention.
The Newark Area, where the ARFC is headquartered, has approximately 27,562 persons living with HIV/AIDS. Newark is also an epicenter of the intersection of domestic abuse and HIV; a growing positive MSM population; has the highest population of female PLWHA in the state; and a large population of youth who are in trouble—in 2014, 23% of homeless served by emergency shelters were under 18 years-old.
Methods : We have a program that trains existing staff at statewide organizations including: Emergency Rooms, Testing Facilities, Detox and Substance Abuse Facilities, Shelters, Domestic Violence Agencies, and all HIV-specific service providers to be Ambassadors of the Collaborative. We call this our Pipeline: a chain of facilities that represent the much needed services for an HIV+ individual facing homelessness. Additionally, we train our ambassadors to be culturally sensitive and conscious of tools to speak through the stigma of HIV . Ambassadors know that the Pipeline is initiated by a call to our 24/7 Hotline. If any PLWHA should call this number at any time, one of our staff will meet them and IMMEDIATELY place them in temporary housing, provide a warm meal, and personal hygiene products. Connecting to people in need at this immediate moment creates a sense of trust and connection. We are able to introduce them to more resources from this point in time.
The Collaborative also trains Ambassadors in providing Trauma-Informed Care. For people impacted by the virus, trauma--particularly unaddressed trauma--can be lethal. Ambassadors are taught first how stigma and trauma can physically accelerate disease progression, and second how to translate this to their clients in a culturally sensitive manner--and connect them with appropriate resources.
We train all providers on varying definitions of homelessness. Many young people we meet do not consider themselves homeless if they are couch-surfing. Neither will an HIV+ woman who has just fled a domestically violent household and has nowhere to go. We train service providers to radically expand their thinking--what qualifies as “homeless” may very well take different iterations. This may be due to the trauma surrounding the disease (entrapment in a dysfunctional home, violence, couch-surfing, etc), but all must be treated as people who are facing homelessness. We cannot expect anyone living in any of those above housing situations to be able to faithfully adhere to treatment, make regular appointments, maintain regular eating habits necessary to taking life-sustaining medication. Further, we cannot expect any of those situations to foster life-sustaining dialogues about honest sexual health information that is free of stigma or shame. Ambassadors, under ARFC’s training, open themselves to new iterations of people who will benefit from housing as healthcare.
Results : Since late October, we have united many community partners and have responded to over 200 PLWHA facing homelessness who have called the Hotline.
Conclusions : The Housing Collaborative is uniting community partners, catalyzing the use of trauma-informed language and care, and ensuring that no Person Living with HIV/AIDS ever spend a night without shelter, community, and a plan to move forward.