Department of Psychiatry and Behavioral Health, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI 53202, USA.
Subst Abuse Treat Prev Policy. 2011 Nov 23;6:31. doi: 10.1186/1747-597X-6-31.
Much research has shown an association between homelessness and unstable housing and HIV risk but most has relied on relatively narrow definitions of housing status that preclude a deeper understanding of this relationship. Fewer studies have examined access to housing subsidies and supportive housing programs among low-income populations with different personal characteristics. This paper explores personal characteristics associated with access to housing subsidies and supportive housing, the relationship between personal characteristics and housing status, and the relationship between housing status and sexual risk behaviors among low-income urban residents.
Surveys were conducted with 392 low-income residents from Hartford and East Harford, Connecticut through a targeted sampling plan. We measured personal characteristics (income, education, use of crack, heroin, or cocaine in the last 6 months, receipt of welfare benefits, mental illness diagnosis, arrest, criminal conviction, longest prison term served, and self-reported HIV diagnosis); access to housing subsidies or supportive housing programs; current housing status; and sexual risk behaviors. To answer the aims above, we performed univariate analyses using Chi-square or 2-sided ANOVA's. Those with significance levels above (0.10) were included in multivariate analyses. We performed 2 separate multiple regressions to determine the effects of personal characteristics on access to housing subsidies and access to supportive housing respectively. We used multinomial main effects logistic regression to determine the effects of housing status on sexual risk behavior.
Being HIV positive or having a mental illness predicted access to housing subsidies and supportive housing, while having a criminal conviction was not related to access to either housing subsidies or supportive housing. Drug use was associated with poorer housing statuses such as living on the street or in a shelter, or temporarily doubling up with friends, acquaintances or sex partners. Living with friends, acquaintances or sex partners was associated with greater sexual risk than those living on the street or in other stable housing situations.
Results suggest that providing low-income and supportive housing may be an effective structural HIV prevention intervention, but that the availability and accessibility of these programs must be increased.
大量研究表明，无家可归和住房不稳定与艾滋病毒风险之间存在关联，但大多数研究依赖于对住房状况相对狭隘的定义，从而无法深入了解这种关系。较少的研究调查了具有不同个人特征的低收入人群获得住房补贴和支持性住房的情况。本文探讨了与获得住房补贴和支持性住房相关的个人特征、个人特征与住房状况之间的关系，以及住房状况与低收入城市居民性风险行为之间的关系。
通过目标抽样计划，对康涅狄格州哈特福德和东哈特福德的 392 名低收入居民进行了调查。我们测量了个人特征（收入、教育、过去 6 个月内使用可卡因、海洛因或冰毒、领取福利金、精神疾病诊断、被捕、刑事定罪、最长刑期和自我报告的艾滋病毒诊断）；获得住房补贴或支持性住房计划的情况；当前住房状况；和性风险行为。为了回答上述目标，我们使用卡方检验或双侧 ANOVA 进行单变量分析。将具有显著水平以上（0.10）的变量纳入多变量分析。我们进行了 2 项单独的多元回归，以确定个人特征对获得住房补贴和获得支持性住房的影响。我们使用多项主要效应逻辑回归来确定住房状况对性风险行为的影响。
艾滋病毒阳性或患有精神疾病预测可获得住房补贴和支持性住房，而刑事定罪与获得住房补贴或支持性住房均无关。吸毒与较差的住房状况有关，如住在街上或收容所，或与朋友、熟人或性伴侣临时合住。与朋友、熟人或性伴侣同住与住在街上或其他稳定的住房情况相比，性风险更高。
结果表明，提供低收入和支持性住房可能是一种有效的结构性艾滋病毒预防干预措施，但必须增加这些计划的供应和可及性。
