The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada
Abstract Background Women living with HIV (WLWH) experience numerous social and structural barriers to stable housing, with substantial implications for access to health care services. This study is the first to apply the Canadian Definition of Homelessness (CDOH), an inclusive national guideline, t...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-022-14113-9 |
| _version_ | 1811265262181154816 |
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| author | Yinong Zhao Kate Shannon Jane A. Buxton Lianping Ti Theresa A. Genovy Melissa Braschel Kathleen Deering |
| author_facet | Yinong Zhao Kate Shannon Jane A. Buxton Lianping Ti Theresa A. Genovy Melissa Braschel Kathleen Deering |
| author_sort | Yinong Zhao |
| collection | DOAJ |
| description | Abstract Background Women living with HIV (WLWH) experience numerous social and structural barriers to stable housing, with substantial implications for access to health care services. This study is the first to apply the Canadian Definition of Homelessness (CDOH), an inclusive national guideline, to investigate the prevalence and correlates of housing status among WLWH in Metro Vancouver, Canada. Methods Our study utilized data from a longitudinal open cohort of cisgender and trans WLWH aged 14 years and older, in 2010–2019. Cross-sectional descriptive statistics of the prevalence of housing status and other social and structural variables were summarized for the baseline visits. Bivariate and multivariable logistic regression analyses were conducted using generalized linear mixed models (GLMM) for repeated measures to investigate the relationship between social and structural correlates and housing status among WLWH. Results The study included 336 participants with 1930 observations over 9 years. Housing status derived from CDOH included four categories: unsheltered, unstable, supportive housing, and stable housing (reference). Evidence suggested high levels of precarious housing, with 24% of participants reporting being unsheltered, 47% reporting unstable housing, 11.9% reporting supportive housing, and 16.4% reporting stable housing in the last six months at baseline. According to the multivariable models, living in the Downtown Eastside (DTES) neighbourhood of Metro Vancouver, hospitalization, physical/sexual violence, and stimulant use were associated with being unsheltered, compared to stable housing; DTES residence, hospitalization, and physical/sexual violence were associated with unstable housing; DTES residence and stimulant use were associated with living in supportive housing. Conclusion Complex social-structural inequities are associated with housing instability among WLWH. In addition to meeting basic needs for living, to facilitate access to housing among WLWH, housing options that are gender-responsive and gender-inclusive and include trauma- and violence-informed principles, low-barrier requirements, and strong connections with supportive harm reduction services are critical. |
| first_indexed | 2024-04-12T20:19:09Z |
| format | Article |
| id | doaj.art-517bc20dc3f840e8b05cc849b3818418 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-12T20:19:09Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-517bc20dc3f840e8b05cc849b38184182022-12-22T03:18:02ZengBMCBMC Public Health1471-24582022-09-0122111010.1186/s12889-022-14113-9The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, CanadaYinong Zhao0Kate Shannon1Jane A. Buxton2Lianping Ti3Theresa A. Genovy4Melissa Braschel5Kathleen Deering6Faculty of Medicine, University of British ColumbiaFaculty of Medicine, University of British ColumbiaFaculty of Medicine, University of British ColumbiaFaculty of Medicine, University of British ColumbiaCentre for Gender and Sexual Health EquityFaculty of Medicine, University of British ColumbiaFaculty of Medicine, University of British ColumbiaAbstract Background Women living with HIV (WLWH) experience numerous social and structural barriers to stable housing, with substantial implications for access to health care services. This study is the first to apply the Canadian Definition of Homelessness (CDOH), an inclusive national guideline, to investigate the prevalence and correlates of housing status among WLWH in Metro Vancouver, Canada. Methods Our study utilized data from a longitudinal open cohort of cisgender and trans WLWH aged 14 years and older, in 2010–2019. Cross-sectional descriptive statistics of the prevalence of housing status and other social and structural variables were summarized for the baseline visits. Bivariate and multivariable logistic regression analyses were conducted using generalized linear mixed models (GLMM) for repeated measures to investigate the relationship between social and structural correlates and housing status among WLWH. Results The study included 336 participants with 1930 observations over 9 years. Housing status derived from CDOH included four categories: unsheltered, unstable, supportive housing, and stable housing (reference). Evidence suggested high levels of precarious housing, with 24% of participants reporting being unsheltered, 47% reporting unstable housing, 11.9% reporting supportive housing, and 16.4% reporting stable housing in the last six months at baseline. According to the multivariable models, living in the Downtown Eastside (DTES) neighbourhood of Metro Vancouver, hospitalization, physical/sexual violence, and stimulant use were associated with being unsheltered, compared to stable housing; DTES residence, hospitalization, and physical/sexual violence were associated with unstable housing; DTES residence and stimulant use were associated with living in supportive housing. Conclusion Complex social-structural inequities are associated with housing instability among WLWH. In addition to meeting basic needs for living, to facilitate access to housing among WLWH, housing options that are gender-responsive and gender-inclusive and include trauma- and violence-informed principles, low-barrier requirements, and strong connections with supportive harm reduction services are critical.https://doi.org/10.1186/s12889-022-14113-9WomenHIVHomelessnessViolenceHealth |
| spellingShingle | Yinong Zhao Kate Shannon Jane A. Buxton Lianping Ti Theresa A. Genovy Melissa Braschel Kathleen Deering The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada BMC Public Health Women HIV Homelessness Violence Health |
| title | The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada |
| title_full | The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada |
| title_fullStr | The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada |
| title_full_unstemmed | The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada |
| title_short | The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada |
| title_sort | prevalence and social structural correlates of housing status among women living with hiv in vancouver canada |
| topic | Women HIV Homelessness Violence Health |
| url | https://doi.org/10.1186/s12889-022-14113-9 |
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