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

Area of Science:

• Public Health
• Social Epidemiology
• Health Services Research

Background:

• Homelessness significantly worsens health outcomes for people with HIV (PWH).
• National HIV prevention strategies from 2009-2014 aimed to decrease homelessness among PWH.
• Understanding sub-national factors is crucial for addressing PWH homelessness.

Purpose of the Study:

• To investigate social ecological factors associated with homelessness among PWH in Delaware between 2009 and 2014.
• To identify reasons for the decline in PWH homelessness observed in Delaware during this period.

Main Methods:

• Utilized national data to identify Delaware as a unique jurisdiction with declining PWH homelessness.
• Analyzed population-level indicators relevant to homelessness.
• Conducted qualitative interviews with six key stakeholders.

Main Results:

• Homelessness among PWH in Delaware correlated with overall homelessness rates, household poverty, and median housing prices.
• Stakeholders highlighted centralized intake systems as key to improving client screening, referrals, and housing connections.
• Delaware was the only jurisdiction showing a decline in PWH homelessness from 2009-2014.

Conclusions:

• Collaborative strategies, alongside social and economic factors, can enhance housing stability for PWH.
• Sub-national trend monitoring is vital for identifying effective interventions and policy needs.
• Centralized intake processes appear to be a successful strategy for improving housing outcomes for PWH.