Monday, October 02, 2006

An urban structural intervention to fight AIDS

In the response to AIDS we need to keep reminding ourselves that it’s not all about individual behaviors.

For example, an AIDS and Behavior article from September 2005 targets housing as a promising structural intervention to reduce the spread of AIDS. The first study of its kind, it collaborated with a national, multi-site evaluation of HIV/AIDS service delivery projects that focused on providing services to low income HIV positive people. The projects were located all over the U.S. in primarily urban settings. Angela Aidala and colleagues then took the data and focused on the correlation between three variables: drug risk behavior and sex risk behavior (dependent variables), and housing status (independent variable). The researchers traced change in individuals’ risk behavior over time as housing status changed. They found that there is a strong association between housing status and HIV transmission; moreover, this association occurs on a gradation, with the homeless at greater risk than the marginally housed, and with both groups at greater risk than the stably housed.

The researchers outline a next step that is needed for action: “data must be produced to show that the provision of housing not only causes a profound reduction in HIV risk-taking but that the risk reductions are so substantial that this is a cost-effective strategy to fight the spread of AIDS in the United States.”

So what’s being done and why aren’t we doing more?

Here’s one model we should be looking at more closely:

Housing Works is a minority-controlled, community-based, not-for-profit corporation providing housing, health care, advocacy, job training, and vital supportive services to homeless New Yorkers living with HIV and AIDS:

Aidala, Angela, J. Cross, R. Stall, D. Harre, and E. Sumartojo “Housing Status and HIV Risk Behaviors: Implications for Prevention and Policy”. AIDS and Behavior, Vol. 9, No. 3, September 2005 (251-265)

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