The Office of National AIDS Policy (ONAP) has been traveling around the country holding a series of HIV/AIDS Community Discussions. We just completed the fourteenth and final community meeting in Caguas, Puerto Rico. One theme that many participants raised is the need to expand access to safe and affordable housing. Over and over again, people made the connection between housing and HIV prevention, and between housing and effective HIV treatment. Given these concerns, the role of housing will be a critical issue in the National HIV/AIDS Strategy (NHAS).
Key questions include the following: Are the housing challenges facing people living with HIV/AIDS primarily a consequence of the nation’s broader housing issues, including the tightening of financial credit? Are these challenges unique to persons with HIV/AIDS or do persons with other chronic diseases share similar experiences? Given where we are now, what are the strategic steps we can take to make progress in expanding access to housing services?
To help answer these questions, ONAP held a meeting with key housing stakeholders last Thursday, December 17, 2009.
During the HIV and Housing meeting, key Administration officials affirmed the President’s commitment to further explore the relationship between HIV and housing – and to strengthen services that support stable housing, which impacts people’s ability to access life-saving care and treatment. Assistant Secretary of Housing and Urban Affairs (HUD) Mercedes Marquez detailed the steps HUD is taking to create a more responsive system that offers easier access, monitors results, and is efficient and accountable. She outlined a more seamless approach to housing assistance service delivery not only within the framework of the HUD program, Housing Opportunity for People with AIDS (HOPWA), but with other programs accessible to people living with HIV/AIDS.
Derek Douglas, Special Assistant to the President for Urban Policy, and Adolfo Carrion, Director and Deputy Assistant to the President, Office of Urban Affairs, described how housing policy fits into a broader conversation that includes education, transportation, economic development and other services that impact people living with HIV/AIDS. Charles King, President and CEO of Housing Works, an HIV/AIDS housing advocacy organization, pointed out the historic nature of this meeting – a meeting on HIV and Housing within the White House and spoke of the opportunity to improve the lives of people with HIV/AIDS by ensuring access to housing.
Participants then quickly got to work on developing a series of recommendations for the NHAS. There were three issue specific breakout sessions - Housing as HIV Prevention and Care, Bringing Successful Strategies to Scale, and the Role of Housing in Systems of HIV Care – each led by issue experts from community based organizations, academia, service providers, state legislators, and private industry. Draft recommendations were summarized during a report back period. These recommendations will be revised during follow up conference calls.
On a personal note, I have seen the positive impact of housing in the lives of people with HIV/AIDS. Prior to moving to Washington, DC, I directed an emergency shelter/hospice for HIV/AIDS patients in Puerto Rico. A fair number of our patients, many of them John/Jane Doe’s, were the product of “patient dumping” where healthcare providers often discharged patients with little planning, often leaving them homeless and on the streets without care or anyone to look out for them because housing support was not available. After a few months under our care (albeit palliative, end of life care), most achieved a far better quality of life before succumbing to their terminal illness. And a few recovered and were placed in more permanent housing. Our efforts certainly testify to the strong restorative bond between accessible housing and HIV/AIDS prevention, treatment and care.
The HIV and Housing meeting was an exciting event that brought together impassioned advocates with leading government officials, both committed to finding common ground and providing meaningful guidance to ONAP and the NHAS effort.
James Albino is the Senior Program Manager in the Office of National AIDS Policy