Changes in Social Networks and HIV Risk Behaviors Among Homeless Adults Transitioning Into Permanent Supportive Housing

Abstract

Permanent supportive housing (PSH) has been recognized by the U.S. federal government as the ''clear solution'' to chronic homelessness. Whether and how access to PSH affects HIV risk is unclear. This mixed methods pilot study uses a convergent parallel design in order to better understand social relationships and HIV risk during the transition from homelessness to PSH. Findings suggest that (a) Sexual activity and HIV risk behaviors increase with housing, (b) Social network size and composition appear to change as individuals transition into PSH, and (c) There is tension between moving forward and leaving behind the past once a person has housing. This study demonstrates that PSH constitutes a specific risk environment that has not been previously investigated.

Risk behavior and access to HIV/AIDS prevention services in a community sample of homeless persons entering permanent supportive housing

“…Further, despite an opportunity for enhanced stability and safety for residents, HIV risk behavior does not necessarily decrease after entry into housing among either seronegative (Henwood et al, 2015) or HIV seropositive residents (Aidala, Cross, Stall, Harre, & Sumartojo, 2005; Wolitski et al, 2010). Being homeless is a barrier to sexual intimacy due to limited privacy and shelter policies separating men and women (Brown, Kennedy, Tucker, Golinelli, & Wenzel, 2013).…”

“…Being homeless is a barrier to sexual intimacy due to limited privacy and shelter policies separating men and women (Brown, Kennedy, Tucker, Golinelli, & Wenzel, 2013). Having one’s own place may facilitate sexual intimacy, but condom use to prevent sexually transmitted infections (STIs) may decrease once one receives housing (Brown et al, 2012; Brown et al, 2013; Henwood et al, 2013; Henwood et al, 2015). These findings point to the importance of understanding need for HIV prevention among homeless persons entering PSH so that providers can ensure that such services are available to residents during this critical time of transition.…”

Understanding Specialist Disability Accommodation funding

“…There is a large and growing literature on the use of mixed methods in social research (see Johnson, Onwuegbuzie et al 2007;Greene 2008), with the capacity to shed light on questions of 'real world' or practical significance (Denscombe 2008). Mixed methods have been used in research on housing and homelessness (see, for example, Brown, Kennedy et al 2013), including in pilot projects (Henwood, Rhoades et al 2017). In common with Investigative Panels, these approaches seek to acquire a wide range of information in a short timeframe and provide the context within which more in-depth analyses and discussions may be framed.…”

Mental health change in the transition to permanent supportive housing: The role of housing and social networks

“…Moreover, research that has examined constructs related to mental health among PSH residents, such as substance use (Rhoades et al, a) and quality of life (Henwood, Matejkowski, Stefancic, & Lukens, ), have indicated that social networks are associated with these outcomes, and, as in the case of quality of life, may facilitate positive change (Henwood et al, ). Transitioning into PSH is also a time of social networks change (Henwood et al, ; Rhoades et al, ); however, whether social networks and social network change are associated with improved mental health symptomatology for PSH residents is unknown.…”

“…In addition studies have found higher levels of social support to be associated with better mental health functioning among persons experiencing homelessness (Cherner et al, ; Hwang et al, ). Empirical evidence also exists to suggest that social networks change in the transition from homelessness to housing (Henwood et al, ; Rhoades et al, ), but it remains to be seen whether those changes are positive or negative. Existing research of PSH residents has indicated residents have small networks, low social support, and commonly struggle with social isolation (Hawkins & Abrams, ; Padgett, Henwood, Abrams, & Drake, ; Tsai, Mares, & Rosenheck, ; Yanos, Barrow, & Tsemberis, ).…”