Housing First and Unprotected Sex: A Structural Intervention

Area of Science:

• Public Health
• Mental Health Services
• Housing Interventions

Background:

• Homeless and precariously housed adults exhibit high rates of STIs and sexual risk behaviors.
• Structural factors, including housing, significantly impact health risk behaviors.
• Supported housing interventions, like Housing First, are hypothesized to reduce sexual risk.

Purpose of the Study:

• To evaluate the effect of Housing First (HF) on unprotected sex.
• To analyze data from a randomized controlled trial.
• To assess outcomes in formerly homeless adults with mental illness and comorbidities.

Main Methods:

• Utilized generalized estimating equations.
• Examined between-group differences in unprotected sex.
• Followed participants for 24 months.

Main Results:

• No significant association was found between HF and reduced unprotected sex.
• HF did not differ from treatment as usual regarding unprotected sex.
• Other variables were independently associated with unprotected sex.

Conclusions:

• Housing First alone may not be sufficient to reduce unprotected sex.
• Additional targeted interventions are necessary.
• Addressing sexual risk in homeless individuals with mental illness requires further research and tailored strategies.