More Than a Shelter
Authors:   , Massie Jenné Shayleen , Villanueva Augusta M. 
Published: July 2021

Background. The Housing Opportunities for Persons with AIDS (HOPWA) Program is a national structural approach designed to address housing instability including providing linkages to health care and mental health services for people living with HIV/AIDS (PLWHA) and their families. While there is literature supporting the association between HOPWA and positive health outcomes, there is a dearth of research examining its broader impact on women living in HOPWA-funded housing. This study focused on the experiences of a cluster of PLWHA living in Washington, DC in need of housing, including the use of photovoice methods, to explore, analyze, and document the impact of HIV/AIDS-sponsored housing services on their lives. Methods. The study's participants (N = 9) and researcher relied on both individual and group photo discussions to create critical discourse, observations, reflections, discussion, feedback, and interpretations of the data collected to gain a culturally-grounded and contextual understanding of the impact that HOPWA-funded housing plays on the lives of WLHA in Washington, DC. The study further used a structured sequential step methodology that included a three-phase process for conducting a photovoice project to engage a cluster of women living in HOPWA-funded housing. Phase 1 of the study included gathering experiential data by conducting personal interviews with the women about their experiences, including their reflections about photos they took, using photovoice methods to accurately identify and describe in detail the essential themes emerging from their personal accounts. Phase 2 of the study involved presentation and group discussion of the experiential themes identified and detailed by the participants. Finally, Phase 3 involved the interpretative phenomenological using the Urban Health Framework and intersectional analyses of this study's research process, including qualitative data collected as part of the above noted Phases 1 and 2. Results. A majority of the women were unfamiliar with the HOPWA program, having acquired stable housing through other HUD programs including, for example, the Housing Choice Voucher Program. Participants perceived access to housing services in DC to be limited in scope, and the process of securing and maintaining stable housing was described as being extremely difficult. The women experienced long waiting times - sometimes extending decades - while seeking to secure housing, and perceived their gender, race, and class as being major barriers to qualifying for some housing opportunities. Some participants noted that their access to housing had a positive impact on their health promoting behaviors and facilitated social support with family and friends by meeting their basic need for shelter and reducing stress. However, the women's experiences with subsidized housing often exposed them to mold, pests, dilapidated structures, violence, and economic and racial segregation caused, in part, by rapid gentrification. The physical and complex social environments faced by these women had a significantly negative effect on both their physical and mental health. Participants asserted that women's HIV/AIDS and housing needs were not being met in DC, and that policymakers were not addressing their priorities as WLHA. Participation in the study had a direct benefit for participants that gained self-empowerment and were able to advocate for improvements in accessing adequate housing through participatory action. Conclusions. Women accessing HIV/AIDS housing-sponsored services in DC were often subjected to sub-standard living conditions, with little power or resources to improve their living conditions. Participation in this study's photovoice project led to engagement in critical dialogue, self-empowerment, and action that resulted in the improvement of some participants' living conditions, as well as advancing advocacy in support of women's HIV/AIDS housing services needs in DC.