Saturday, November 29, 2008

Saturday, November 8, 2008

Testimony Supporting Supportive Housing Services
City Council Hearing, October 31, 2008
Submitted by Karyn L. Pomerantz, Metropolitan Washington Public Health Association

The Metropolitan Washington Public Health Association strongly supports supportive housing initiatives, such as Housing First, to provide housing stability to residents of the District of Columbia. We are especially concerned about housing the 220 people on the Housing Opportunities for People with AIDS waiting list as well as the 25,000 people on the Section 8 waiting list whose vulnerability to HIV is increased because of their housing status:

1. HIV infection rates are 3-16 times higher among people without stable housing (1).

2. Up to 70 percent of people with AIDS report a lifetime experience of homelessness (2).

3. Housing status predicts health status for people with AIDS among people with the same drug and mental health problems, and use of social and medical services (3).

Housing supports the health objectives of the District of Columbia, specifically the reduction of HIV rates through these pathways:

1. People who are homeless or in unstable housing situations are 2 to 6 times more likely to engage in risky sexual and drug-related activities than similar people who are well housed (4).

2. People who found stable housing reduced their risky activities by 50 percent compared to others who were more likely to exchange sex for housing (5).

3. Stable housing allows people with HIV to adhere to their medication schedules, which reduces the viral load in an individual and therefore reduces the risk of HIV transmission to others in the community (6).

Therefore, we urge the Council to expand this program with the appropriate supportive services (counseling, rent subsidies, substance use and mental health treatment as desired). We also urge the Council to maintain its shelter system for those losing their housing or jobs so that people are not forced to live on the street while waiting on the housing lists. This includes re-opening the Franklin Shelter and ensuring that the men moved from the Shelter into supportive housing have the necessary follow-up to maintain their housing.

(1) Kerker B et al. (2005) The health of homeless adults in NYC. NYC Depts of Health and Mental Hygiene.
(2) Aidala A et al. (2007) Housing need, housing assistance, and connection to medical care. AIDS & Behavior, 11(6)/Supp2:S101-S115.
(3) Kidder DP et al. (2007) Health status, health care use, medication use, and medication adherence in homeless and housed people living with HIV/AIDS. American Journal of Public Health. 97(12):2238-2245.
(4) Wolitski R; Kidder D; Fenton F. (2007) HIV, homelessness, and public health. AIDS & Behavior, 11(6)/Supp2:S167-171.
(5) Aidala A; Cross J; Stall R; Harre D; Sumartojo E. (2005). Housing status and HIV risk behaviors. AIDS & Behavior 9(3):251-265.
(6)Wolitski et al. (2007). What works, and what remains to be done, in HIV prevention in the United States. Annual Review of Public Health. 27:261-275.