Reducing Homelessness among Persons with HIV: An Ecological Case Study in Delaware

Among persons with HIV (PWH), homelessness is associated with poorer health. From 2009-2014, national HIV prevention goals included a reduction in homelessness among PWH. We sought to examine social ecological factors associated with homelessness among PWH at a sub-national level during that period.

National data were used to identify Delaware as the only jurisdiction where homelessness among PWH declined from 2009-2014. We analyzed population-level indicators and conducted telephone interviews with 6 key stakeholders to further examine this trend.

Overall homelessness, household poverty, and median housing price were associated with homelessness among PWH in Delaware. Key stakeholders indicated that centralized intake processes improved screening, referral, and linkages of clients to housing units.

In addition to social and economic factors, collaborative program strategies may improve housing outcomes for PWH. Monitoring trends at sub-national levels can help identify successful approaches as well as needed services or policy change.