Precarious Housing Associated with Unsuppressed Viral load, sub-optimal Access to HIV Treatment and Unmet Health care Needs, Among Women Living with HIV in Metro Vancouver, Canada

Sex differences in houselessness, injection drug use, and mental health conditions among people newly diagnosed with HIV in Manitoba, Canada from 2018 to 2021: a retrospective cohort study

“…It is well established that houselessness is a barrier to accessing other health services such as addiction care. 18 A recent study in Vancouver, Canada found that 71·7% of a cohort of women living with HIV reported houselessness or unstable housing in the last six months, 21 and houselessness was associated with decreased progression through the cascade of HIV care. 21 Our data further adds to these findings by showing the confluence between methamphetamine (mostly injected use), female sex, and houselessness, highlighting the need to approach HIV treatment through a syndemic framework.…”

Pathways From Recent Incarceration to Antiretroviral Therapy Adherence: Opportunities for Interventions to Support Women Living With HIV Post Release From Correctional Facilities

“…However, evidence suggests that transitional housing in Canada remains limited and unsafe for women (National Inquiry into Missing and Murdered Indigenous Women and Girls, 2019a), and our findings elucidate an urgent need for resources dedicated to increased gender-specific housing options upon release from correctional settings. Given the high rates of gender-based violence among marginalized women who experience incarceration (Erickson, Pick, Ranville, Martin et al, 2020; McMillan et al, 2021), along with research highlighting the relationship between gender-based violence and housing precarity among women living with HIV specifically (Zhao, 2021), there is an ongoing need for gender-specific approaches to housing stability (Desai, 2012; Fotheringham et al, 2014). Housing options could include self-contained units in women-only buildings (Currie, 2004; Desai, 2012), along with communal areas that foster social support surrounding community reintegration, and supports for women who have children (Desai, 2012; Ghose et al, 2019).…”

“…Central to this work of course is the emphasis on client-centered care that provides meaningful options and choice when it comes to housing options and associated supports (Centre for Addictions Research of BC, 2011; Desai, 2012). The inclusion of harm reduction principles (National Harm Reduction Coalition, 2021) within housing strategies (Centre for Addictions Research of BC, 2011), ensuring that gender-specific housing options are also within proximity to preexisting harm reduction and substance use services (Zhao, 2021) and supporting women to access services tailored to their individual goals and needs (Springer et al, 2011), will be essential in supporting women's health and well-being. Finally, to redress the overincarceration of marginalized women, decriminalizing illicit substance use, and ending the war on drugs remains paramount (Canadian Drug Policy Coalition, 2021; Carter & MacPherson, 2013; Wood et al, 2010).…”

“…Findings from the US demonstrate that among people living with HIV, women are significantly more likely to report both homelessness and criminalized substance use following incarceration (Meyer et al, 2014), factors that are also associated with increased rates of recidivism (Fu et al, 2013). Furthermore, research has shown that housing insecurity or homelessness (Cornelius et al, 2017; Duff et al, 2016; Kerkerian et al, 2018; Zhao, 2021) and substance use (Chitsaz et al, 2013; Friedman et al, 2009; Goldenberg et al, 2016; Gonzalez et al, 2013; Haley et al, 2014; Kerkerian et al, 2018; Zhang et al, 2018)—by way of interference and impairment in daily life (Gonzalez et al, 2011)—can create barriers to optimal HIV health, including through impacts on suboptimal ART adherence and unsuppressed viral load. Unsurprisingly, stable housing can assist in both reducing relapse to substance use in the postrelease period as well as facilitating adherence to ART (Buchanan et al, 2009; Ghose et al, 2019).…”

Brief Report: Social Factors Associated With Trajectories of HIV-Related Stigma and Everyday Discrimination Among Women Living With HIV in Vancouver, Canada: Longitudinal Cohort Findings

“…Other explanatory variables captured recent (past 6 months) events at baseline: age (continuous); physical and/or sexual violence experiences (any); injection drug use (daily, less than daily, or none); noninjection drug use (daily, less than daily, or none); food insecurity (modified Cornell-Radimer hunger scale, 28 as previously described 29 ); and housing insecurity (Canadian Observatory of Homelessness definition of unsheltered/unstably housed, 30 as previously described). 31 We created a composite variable for food and/or housing secure (having both or just one of food security or housing security) vs. food and housing insecure (having both food and housing insecurity concurrently).…”