Care, well-being, and quality of life of people living with HIV and AIDS
Abstract Format : Background: Literature supports the association between HOPWA and positive health outcomes, but there is a dearth of research examining its broader impact on women living in HOPWA-funded housing. “More than a Shelter”, a photovoice project, comprises the work of 9 Black women living with HIV/AIDS (WLHA) recruited to explore their experiences with housing services in Washington, DC.
Methods : Methods: The three-phase photovoice process used individual and group photo discussions to create critical discourse and interpretations of the data in Phases 1 and 2. Phase 3 involved interpretative phenomenology, using the Urban Health Framework and intersectional analyses of the research process from Phase 1 and 2 data.
Results : Results: After long stents cycling between homelessness, shelters and transitional housing, majority of the participants acquired stable housing through HUD programs other than HOPWA, including the Housing Choice Voucher Program. Participants perceived housing services in DC as limited and believed the arduous process for securing and maintaining stable housing was complicated by barriers related to their gender, race, and class. Some participants documented hazardous physical living conditions and social environments in the form of chronic exposure to mold, pests, dilapidated structures, crime and violence. The women discussed the negative impact that the hazardous physical conditions and vulnerability linked to the social environment of their homes and neighborhoods had on their physical, mental and emotional health, as well as on their families. Due to their social position as low-income Black women, the participants believed they had limited mobility and power to advocate for their rights to sanitary and safe housing and health. Ultimately, participants perceived that local policymakers viewed the housing and HIV/AIDS service needs of women living with HIV/AIDS (WLHA) as secondary to other key populations, particularly men that have sex with men (MSM) and transgender women.
Conclusions : Conclusion: While we continue to chant the “housing equals health” mantra, public health professionals must also advocate for the primacy of quality of housing. WLHA accessing housing services in DC in the current study were often subjected to sub-standard living conditions, with little power or resources to improve their living situation. Housing can improve health, but only if the housing units are habitable. The current study highlights the importance for public health and HIV/AIDS advocates to focus not just on housing, but also on health and quality of life, and empowering WLHA to advocate for the enforcement of housing codes. Findings also indicate the need for policymakers and advocates to adopt an intersectional lens to foster effective engagement approaches with WLHA to ensure their voices and needs are being heard, understood, and responded to.