Gentrification and HIV: Why Aren’t We Talking About the Crucial Link Between Housing and Health Care?

Picture this. You check in with your doctor. They write you a prescription. You get the order filled. You return to the tent you’ve been sleeping in. You hear something during the night, rustling. You’re too afraid to see who it is. In the morning, you realize someone’s stolen your medication. What do you do? Where do you go for help? If you do manage to get a new prescription, will someone steal it again?

When you don’t have access to stable housing, consistently taking medication isn’t always an option. Going to the doctor isn’t always an option. And when you’re living with HIV and don’t have access to stable housing, the obstacles to finding and sustaining medical treatment multiply.

So, when we’re talking about HIV prevention and treatment, why doesn’t housing come up more in the discussion? Especially when, due to discrimination in the workplace, up to 50% of people living with HIV and AIDS are at risk of becoming homeless.

While many scholarly articles focus on the connections between homelessness and HIV, these connections don’t get mentioned very often in mainstream discussions regarding gentrification and the rising homelessness crisis.

At first glance, it might seem like gentrification and HIV are relatively unrelated topics. But when you think about homelessness as a consequence of rising rents and out of control gentrification, it starts to make more sense.

It’s common knowledge in the health care world that staying in consistent care is paramount to decreasing the spread of HIV and keeping individuals’ viral loads suppressed. When HIV positive people are in regular care, the virus can become undetectable and untransmittable. That means when people are taking their medication regularly, and they reach a specific viral load, they can’t transmit the disease to another person.

That’s why countless AIDS organizations across the country either provide housing resources or partner with organizations that do. When people have a stable home, they become much more likely to stay in care. The U.S. government even recognizes this connection and began “HOPWA” or Housing Opportunities for Persons with AIDS in 1992 to help people living with HIV and AIDS access housing and remain in care.

Here at AIDS Healthcare Foundation, we also recognize the importance of housing. In 2018, we started the Healthy Housing Foundation to give our patients and those in need access to stable housing. We also began the Housing Is A Human Right advocacy branch of our organization. We believe that permanent housing is a fundamental right, not only for our patients but for everyone.

Even though the connections between housing and HIV prevention are clear, when these two do come up in discussions, not everyone understands why an AIDS organization would care about housing or devote any resources to fighting gentrification. But when you take a closer look, it’s clear to see that stable housing plays a vital role in improving overall health and HIV prevention.

There have been multiple studies done that link access to stable housing to positive health outcomes. These studies show how housing, educational attainment, employment, and the environment, or what they refer to as “social determinants of health,” play a dramatic role in health inequities. These studies show that “in order to achieve the ‘triple aim’ of improving population health…the health system must take a broader approach to health care,” starting with the most basic social determinant of health, access to safe, quality, affordable housing.

So, why don’t we talk about the clear link between health care and stable housing more often? It seems like so many discussions surrounding housing and gentrification get derailed by Nimbyism or are bogged down in misguided bureaucracy.

If we devoted more time to clearly establishing the link between HIV prevention and preventing homelessness as a consequence of gentrification, we could start a cultural shift and bring social determinants of health into the mainstream zeitgeist. If we saw these things as vital to fighting the spread of HIV and AIDS, we would see more action on providing education, employment opportunities, and most importantly, housing.