Housing Characteristics and their Influence on Health-Related Quality of Life in Persons Living with HIV in Ontario, Canada: Results from the Positive Spaces, Healthy Places Study

Abstract

Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and mental health-related quality of life. We found significant cross-sectional associations between housing and neighborhood variables—including place of residence, housing affordability, housing stability, and satisfaction with material, meaningful and spatial dimensions of housing—and both physical and mental health-related quality of life. Our analyses also revealed longitudinal associations between housing and neighborhood variables and health-related quality of life. Interventions that enhance housing affordability and housing satisfaction may help improve health-related quality of life of people living with HIV.

Not Just “A Roof over Your Head”: The Meaning of Healthy Housing for People Living with HIV

“…For people with HIV, current evidence supports the claim that the provision of safe, affordable, stable housing is crucial to mental, physical and social well-being and that stable housing can make a significant contribution to improvements in medication adherence, mental health, social support and overall health (Greene et al 2010Monette et al 2009Monette et al , 2011Rourke et al 2011Rourke et al , 2012Smith and Pynoos 2002).…”

“…Housing literature has noted the particular vulnerability of HIV-positive people to housing insecurity and homelessness (Aidala 2005;Culhane et al 2001;Evans and Strathdee 2006;Kidder et al 2008;Rourke et al 2012). Research evidence has consistently indicated the financial or economic vulnerability of people with HIV across the social stratum, particularly their challenges with managing their housing, income, employment and treatment requirements (Mahamoud et al 2012).…”

“…The specific health vulnerabilities of people with HIV, such as compromised immunity, health co-morbidities, treatment adherence, and illness and treatment side effects, can put those without stable housing at greater risk of poorer health. Study findings on housing instability and health for people with HIV indicate that those who are unstably housed experience worse mental and physical health outcomes, have lower CD4 counts, have higher viral loads, suffer higher rates of mortality, are more likely to be admitted to a hospital or to emergency care and are less likely to be on antiretroviral therapy (ART) or to regularly adhere to ART (Leaver et al 2007;Kidder et al 2007;Rourke et al 2012;Shubert and Bernstine 2007).…”

Estigmatização de pessoas que vivem com HIV/aids e sua relação com suporte social e qualidade de vida

“…A condição de moradia está estreitamente ligada ao trabalho e à renda, sendo a conquista da casa própria ou da manutenção mensal do aluguel ligadas à satisfação com a QV percebida (ROURKE et al, 2016).…”

“…Para Rourke et al (2016), o baixo custo da habitação está associado diretamente à melhor QV física e mental, em especial para aqueles com renda fixa, pela possibilidade de manter a compra de itens necessários à promoção da saúde, como alimentação, recreação e cuidados pessoais; e pela possibilidade de manter os custos, evitando ameaças de perder a habitação devido ao aumento do aluguel ou de hipotecas que poderão aumentar a ansiedade e o estresse.…”