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

Abstract

The literature has identified housing as a fundamental unmet need for people living with HIV; yet there has been little qualitative evidence exploring housing and HIV, particularly from a Canadian context. This paper focuses on our qualitative analyses of the housing experiences of 48 HIV-positive people living in Ontario. Findings from our interviews illustrate healthy housing as a dynamic interconnection between health, housing and other social factors that are influential to the health and well-being of people with HIV. Four salient themes have emerged from our qualitative findings: the interplay between healthy housing and economic security; the relationship between HIV, health and housing precariousness; the interconnection between housing, HIV, safety, stigma, social isolation and social exclusion; and the meaning of healthy housing for people living with HIV. These findings reemphasize the importance of housing policies that consider housing as more than just a roof over one's head, but also as something that supports the physical, mental, emotional and social well-being of people living with HIV. This article is dedicated to the memory of LaVerne Monette, co-investigator with the Positive Spaces, Healthy Places (PSHP) research project, who passed away on December 1, 2010. Responsible for the Aboriginal arm of the study, she played a key role in developing the larger study. She brought to our team her life experiences as an Aboriginal woman and her passion to help Aboriginal people living with and at risk of HIV. She understood the critical role of housing in health and quality of life, and was a strong advocate for research to identify the housing needs of Aboriginal people in Ontario and for policy change that will lead to safe, stable housing for all.

Revisiting the Housing–Health Relationship for HIV-Positive Persons: Qualitative Evidence From the Lower Manya Krobo District, Ghana

“…If PLWHAs feel stigmatized in their own homes, the home stops being a place of refuge and becomes an emotionally perilous place. For the PLWHAs we interviewed, the worry about housing went beyond the lack of basic amenities; they also reported fear, helplessness, tenure insecurity, anxiety, and depression living in places where their own family members and neighbors treated them as "intruders" and social threats (see also Chambers et al, 2014). It is one thing being rejected by strangers, but when one feels rejected by loved ones or people one feels strongly connected to because of HIV/AIDS, there is no treatment strong enough to "cure" the pain and the shame.…”

“…Because they feared being stigmatized by family members and neighbors, some relocated from decent to deplorable housing units. Their relocation and isolation exacerbated their already poor health condition (Chambers et al, 2014).…”

Social Exclusion and Health: The Development of Nursing Knowledge

“…Internationally, much headway has been made in research examining health and social exclusion. In Canada, however, researchers investigating the subject have tended to focus on material deprivation and poverty (Stewart et al, 2008;Wilson et al, 2007), while some are starting to go beyond this focus and employ a broader, social determinants of health approach (Chambers et al, 2014;Reid, 2004). Further, in Canada there has been limited exploration by nursing scholars that includes a discussion of the relevance and implications of social exclusion for nursing.…”

Understanding the impact of a residential housing programme for people living with HIV/AIDS: a realist evaluation protocol

“…Housing instability and homelessness are significant barriers to medical treatment for people living with HIV/AIDS (PLHIV). 1–3 Although housing is a human right 4 and a top service priority for PLHIV, 5 obtaining stable, safe housing is challenging for these individuals. HIV-related stigma has prevented PLHIV from obtaining and maintaining safe places of residence.…”

“…HIV-related stigma has prevented PLHIV from obtaining and maintaining safe places of residence. 1 6 Qualitative accounts illustrate instances of property defacement, neighbourhood gossip and threatening letters tied to one’s HIV status. 1 6 Furthermore, PLHIV are often unemployed, have difficulty affording housing costs and, therefore, may be unable to afford safe housing.…”