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The Effects of Housing Status, Stability and the Social Contexts of Housing on Drug and Sexual Risk Behaviors

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Abstract

Research on the relationship between housing instability and HIV risk has often focused on two different conceptions of stability. In one conceptualization, housing stability is defined according to physical location with homeless or unstably housed individuals defined as those who reside in places not meant for human habitation or in emergency shelters. The other conceptualization has defined housing stability as individuals’ degree of transience, often operationalized as the number of moves or evictions a person has had within a specified amount of time. Less studied has been the social context of living situation, e.g. living with other drug users, conflict over living expenses, or having to have sex in order to stay. This paper uses data from 392 low-income residents in Hartford, CT to explore how people in different housing situations—including those who are housed and homeless—experience housing stability, feelings of security in their homes, and the social context of their housing. We then explore how these varied measures of housing context affect drug use frequency and sexual risk. Results show that participants who are homeless feel more overall housing instability in terms of number of moves and negative reasons for moving. Those who were doubled up with family or friends were more likely to experience conflict over household expenses and more likely to live with drug users. Among homeless and housed, hard drug use was associated with experiencing violence in the place where they lived, perceiving greater housing stability, having moved for a positive reason, doubling up, and longer periods of homelessness, while number of moves and longer prison sentence predicted sexual risk. Among the housed, living with other drug users was associated with more hard drug use, while contributing money toward household expenses was associated with less hard drug use. Two significant interactions were associated with sexual risk among the housed. Those with longer prison sentences who lived with drug users had more sexual partners, and those with longer prison sentences who doubled up had more sex partners. Results of this study indicate that measures of housing status not often considered in the literature such as the social context of housing have significant effects on HIV risk.

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Funding

The research presented in this paper was funded by grants from the National Institute on Drug Abuse (R01DA027299) and National Institute of Mental Health (P30MH57226).

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Authors and Affiliations

  1. Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA

    Julia Dickson-Gomez, Timothy McAuliffe & Katherine Quinn

Authors
  1. Julia Dickson-Gomez
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  2. Timothy McAuliffe
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Correspondence to Julia Dickson-Gomez.

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Conflict of interest

Julia Dickson-Gomez declares she has no conflict of interest. Timothy McAuliffe declares that he has no conflict of interest. Katherine Quinn declares she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Dickson-Gomez, J., McAuliffe, T. & Quinn, K. The Effects of Housing Status, Stability and the Social Contexts of Housing on Drug and Sexual Risk Behaviors. AIDS Behav 21, 2079–2092 (2017). https://doi.org/10.1007/s10461-017-1738-1

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