Archives of Women's Mental Health

, Volume 13, Issue 3, pp 223–232 | Cite as

Under My Umbrella”: The housing experiences of HIV positive parents who live with and care for their children in Ontario

  • Saara Greene
  • Ruthann Tucker
  • Sean B. Rourke
  • LaVerne Monette
  • Jay Koornstra
  • Michael Sobota
  • Steve Byers
  • Stephen Hwang
  • James Dunn
  • Dale Guenter
  • Amrita Ahluwalia
  • James Watson
Original Contribution

Abstract

Positive Spaces, Healthy Places (PSHP) is the first longitudinal community-based research (CBR) initiative in Canada to examine housing stability and its relationship to health related quality of life (HRQOL) for people living with of HIV/AIDS (PHAs). As part of our mixed method data collection strategy in-depth, semi-structured interviews were conducted with 50 PHAs across Ontario to provide a deeper understanding of the impact that housing instability has on their mental and physical health. Emerging from the qualitative interviews were the unique issues and concerns that were reported by parents who live with and care for their children. These parents face dire housing, economic and social challenges that are associated with significant risks for poor health outcomes. Poor housing conditions, unsafe neighborhoods, barriers to supports for themselves and their children, HIV related stigma, discrimination, racism, and poverty have been identified by these families as being among their most pressing concerns. This results in increased stress and anxiety that has a negative impact on the mental health of HIV positive parents. In order to more effectively support HIV positive parents and their children, health and social service practices and policies must respond to the unique challenges that face these families.

Keywords

HIV Families Mothers Housing instability Mental health 

References

  1. Aidala A, Cross JE, Stall R, Harre D, Sumartojo E (2005) Housing status and HIV risk behaviors: implications for prevention and policy. AIDS and Behavior 9:1–15CrossRefGoogle Scholar
  2. AIDS Bureau (2007) Building Bridges: an analysis and summary of the HIV/AIDS community planning initiative in Ontario, Ministry of Health and Long Term CareGoogle Scholar
  3. Antle B, Wells L, Salter Goldie R, Matteo D, King S (2001) Challenges of parenting for families living with HIV/AIDS in. Social Work 46(2):159–169PubMedGoogle Scholar
  4. Bryant T (2004) Housing and health. In: Raphael D (ed) Social determinants of health: Canadian perspectives. Toronto, ON, Canadian Scholars PressGoogle Scholar
  5. Cheung AM, Hwang SW (2004) Risk of death among homeless women: a cohort study and review of the literature. Can Med Assoc J 170(8):1243–1247CrossRefGoogle Scholar
  6. Culhane DP, Gollub E, Kuhn R, Shpaner M (2001) The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilization in Philadelphia. J Epidemiol Community health 55:515–520CrossRefPubMedGoogle Scholar
  7. DeMatteo D, Wells LM, Salter Goldie R, King SM (2002) The ‘family’ context of HIV: a need for comprehensive health and social policies. AIDS CARE 14(2):261–278CrossRefPubMedGoogle Scholar
  8. Dunn JR (2000) Housing and health inequalities: review and prospects for research. Housing Studies 15(3):341–366CrossRefGoogle Scholar
  9. Dunn JR, Hays MV, Hulchanski D, Hwang SW, Potvin L (2004) Housing as a socio-economic determinant of health: a Canadian research framework. In: Howden-Chapman P, Carroll P (eds) Housing and health: research, policy and innovation. Steele Roberts, Wellington, pp 12–39Google Scholar
  10. Duran B, Butlerys M, Iralu J, Graham C, Edwards A, Harrison M (2000) American Indians with HIV/AIDS: health and social service needs, barriers to care, and satisfaction with services among a Western tribe. Am Indian Alsk Native Ment Health Res 9(2):22–36Google Scholar
  11. Enriquez M, Farnam R, Simpson K, Grantello S, Shandor MM. (2007). Pregnancy, poverty and HIV in, The Journal of Nurse Practitioners, pp.687–693Google Scholar
  12. Fisher B, Hovell M, Hofstetter CR, Hough R (1995) Risks associated with long-term homelessness among women: battery, rape and HIV infection. Int J Health Serv 25:351–369PubMedGoogle Scholar
  13. Frankish CJ, Hwang CW, Quantz D (2005) Homelessness and health in canada: lessons and priorities. Can J Public Health 96(Suppl 2):s23–s29PubMedGoogle Scholar
  14. Geduld J, Gatali M, Remis R, Archibald CP (2003) Estimates of HIV prevalence and incidence in Canada. CCDR 2003 29:197–206Google Scholar
  15. Gielen AC, McDonnell KA, Burke JG, O’Campo P (2000) Women's lives after HIV positive diagnosis: disclosure and violence. Matern Child Health J 4(2):111–120Google Scholar
  16. Greene S, Tucker R, Rourke SB, Monet L, Sobota M, Koornstra J, Byers S, Hwang S, Dunn J, Guenter D (2007) Significant housing, economic and social challenges for people with HIV who are living with and caring for their children: result from the positive spaces, healthy places research study. NIMH Annual International Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, July 24–27th, San FranciscoGoogle Scholar
  17. Hwang SW (2001) Homelessness and health. Can Med Assoc J 164(2):229–233Google Scholar
  18. Ingram D, Hutchison S (1999) Defensive mothering in HIV positive mothers. Qual Health Res 9(2):243–258Google Scholar
  19. Kappel Ramji Consulting Group (2002) Common occurrence: the impact of homelessness on women’s health. Phase II: Community Based Action Research-Final Report, TorontoGoogle Scholar
  20. Kilbourne A, Herndon B, Andersen RM, Wenzel SL, Gelberg L (2002) Psychiatric symptoms, health services, and HIV risk factors among homeless women. Journal of Health Care for the Poor and Underserved 13(1):49–65CrossRefPubMedGoogle Scholar
  21. Kushel MB, Gupta R, Gee L, Hass JS (2006) Housing instability and food insecurity as barriers to health care among low income Americans. J Gen Intern Med 21(1):71–77CrossRefPubMedGoogle Scholar
  22. Lawson E, Gardezi F, Calzavara L, Husbands W, Myers T, Tharao WE (2006) HIV/AIDS, stigma, denial, fear and discrimination: experiences and responses of people from African and Caribbean communities in Toronto. African and Caribbean Council on HIV/AIDS (ACCHO) and the HIV Social, Behavioral and Epidemiological Studies Unit, Department of Health Sciences, University of TorontoGoogle Scholar
  23. Leaver CA, Bargh G, Dunn J, Hwang S (2007) The effects of housing status on health related outcomes in people living with HIV: a systematic review of the literature in. AIDS and Behavior 11(2):85–100CrossRefPubMedGoogle Scholar
  24. Leserman J, Ironson G, O’Cleirigh C, Fordiani JM, Balbin B (2008) Stressful life events and adherence in HIV. AIDS Patient Care STDS 22(5):403–411CrossRefPubMedGoogle Scholar
  25. Li A, Gillis L, Woolcott L, et al (2001) Improving access to legal services and health care for people with HIV/AIDS who are immigrants, refugees or without status in Canada. Toronto: Committee for Accessible AIDS TreatmentGoogle Scholar
  26. McGowan J, Shah S (2000) Prevention of perinatal HIV transmission during pregnancy. J Antimicrob Chemother 46:657–668CrossRefPubMedGoogle Scholar
  27. McKeown I, Reid S, Turner S, Orr P (2002) Sexual violence and dislocation as social risk factors involved in the acquisition of HIV among women in Manitoba, The Prairie Women’s Health Centre of Excellence, Project #25Google Scholar
  28. Murphy D (2006) FEANTSA, Prepared for the 2006 ENHR Conference, Workshop 5 “The Residential Context of Health” Brussels, June 2006Google Scholar
  29. Nelson G, Sylevestre J, Aubry TJ, George L, Trainor J (2007) Housing choice and control, housing quality, and control over professional support as contributors to the subjective quality of life and community adaptation of people with severe mental illness. Adm Policy Ment Health 34(2):89–100Google Scholar
  30. Ontario Advisory Committee on HIV/AIDS (2002). A proposed HIV/AIDS Strategy for Ontario to 2008Google Scholar
  31. Parish M, Burry C, Pabst MS (2003) Providing comprehensive case management to urban women with HIV/AIDS and their families in. Affilia 18:302CrossRefGoogle Scholar
  32. Peressini T, McDonald L (2000). Urban homelessness in Canada. In: Bunting T, Filion P (eds) Canadian cities in transition. Oxford University PressGoogle Scholar
  33. Pequegnat W, Bray JH (1997) Families and HIV/AIDS: introduction to the special section. J Fam Psychol 11:3–10CrossRefGoogle Scholar
  34. Phelan JC, Link BG (1999) Who are the “homeless”? Reconsidering the stability and composition of the homeless population. Am J Public Health 89:1334–1338Google Scholar
  35. Remis RS (2006) Report on HIV/AIDS in OntarioGoogle Scholar
  36. Remis RS, Swantee C, Schiedel L, Liu J (2008) Report on HIV/AIDS in Ontario 2006Google Scholar
  37. Rotheram-Borus MJ, Weiss R, Alber S, Lester P (2005) Adolescent adjustment before nd after HIV-related parental death. J Consult Clin Psychol 73(2):221–228CrossRefPubMedGoogle Scholar
  38. Salter Goldie R, De Matteo D, Wells L, Aykroyd G, King S (2000) Social planning in canada for families with HIV infection in. Can J Public Health 91(5):353–356Google Scholar
  39. Shelton D (1993) Issues related to health care utilization and medical adherence among prenatal HIV seropositive African-American women in Miami: the role of the family and the extended 50 kinship network. Fam Syst Med 11:1–14CrossRefGoogle Scholar
  40. Song J (2003) AIDS housing of Washington. AIDS Housing Survey, p.1Google Scholar
  41. Stewart MJ, Neufeld A, Harrison MJ, Spitzer D, Hughes K, Makwarimba E (2006) Immigrant woman family caregivers in Canada: implications for policies and programmes in health and social sectors in. Health Soc Care Community 14(4):329–340CrossRefPubMedGoogle Scholar
  42. Tischler V, Karim K, Rustall S, Gregory P, Vostanis P (2004) A family support service for homeless children and parents: users perspectives and characteristics in. Health Soc Care Community 12(4):327–335CrossRefPubMedGoogle Scholar
  43. Tischler V, Rademeyer A, Vostanis P (2007) Mothers experiencing homelessness: mental health, support and social care needs in. Health Soc Care Community 15(3):246–253PubMedCrossRefGoogle Scholar
  44. Tremblay J, Ward J (1998) Homeless voices: follow-up to the homeless, not helpless report. Toronto Health City Office, TorontoGoogle Scholar
  45. Waegemakers Schiff J (2007) Homeless families in Canada: discovering total families. Families in Society 88(1):131–140Google Scholar
  46. Weinreb L, Goldberg R, Lessard D, Perloff J, Bassuk E (1999) HIV-risk practices among homeless and low-income housed mothers. J Fam Pract 48:859–867PubMedGoogle Scholar
  47. Wenzel SL, Tucker J, Elliot M, Hambarsoomian K (2007) Sexual risk among impoverished women: understanding the role of housing status. AIDS and Behavior 11(2):9–20Google Scholar
  48. Zierler S, Krieger N (2000) Social inequality and HIV infection in women. In: Mayer K, Pizer HF (eds) The emergence of AIDS: the impact on immunology, micorbiology and public health. American Public Health Association, Washington, DCGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Saara Greene
    • 1
  • Ruthann Tucker
    • 1
  • Sean B. Rourke
    • 1
  • LaVerne Monette
    • 1
  • Jay Koornstra
    • 1
  • Michael Sobota
    • 1
  • Steve Byers
    • 1
  • Stephen Hwang
    • 1
  • James Dunn
    • 1
  • Dale Guenter
    • 1
  • Amrita Ahluwalia
    • 1
  • James Watson
    • 1
  1. 1.School of Social Work, McMasters UniversityHamiltonCanada

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