Homelessness and HIV are linked, Durham advocates say. How city can address them
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- Advocates in Durham urge integration of housing and health care for HIV patients.
- HOPWA funds remain under-used as local systems block access to essential support.
- Black and Latino residents face disproportionate HIV rates amid broken services.
Stable housing is key to reducing the number of people living with HIV and AIDS, and advocates say Durham County needs to do more.
Without consistent housing or health care, people with HIV miss medical appointments, have difficulty getting medication, and are at increased risk of transmitting the virus to others, according to the Coalition to End HIV in Durham.
On Tuesday morning, Hayley Cunningham, president of the coalition and an infectious disease doctor at Duke University, joined others in urging city and county leaders to adopt a data-driven system of care that integrates housing and health services for people with HIV in Durham County.
Lack of coordinated support has led to preventable deaths from a disease they said should “be easier to treat than arthritis.”
“I am seeing young people in their 20s dying of AIDS, and that’s not acceptable when we have these medications,” Cunningham said. “And there’s just other things on their mind, like having housing, like being able to get a job, like putting food on the table — or, you know, maybe folks don’t have a table.”
Two years ago, the coalition asked for support getting a Housing Opportunities for Persons with AIDS, or HOPWA, grant that would have provided $2.5 million to create a system of care for this population, but the coalition never got a letter of support from the city, Cunningham said.
The coalition is also working to have a standalone facility to collaborate with its partners to address the epidemic.
Durham County gets millions in federal HOPWA funding from the Department of Housing and Urban Development, but advocates say the money is not always making it to those who need it.
“We have a lot of people that are applying for HOPWA funding or applying for [housing] vouchers, but they’re not actually receiving those vouchers, and so that system is making it very difficult for our population to receive those services,” said Lanea Foster, the founder of Southeast Community Resources.
The coalition wants support from the city and county to develop a dashboard for data sharing and to create a collaborative, comprehensive support model. Last month, the city of Durham issued a Request for Proposals for local groups to disburse HOPWA funding. Foster said more support is needed from the county.
HIV, or human immunodeficiency virus, attacks the body’s immune system. Without proper treatment, it can lead to AIDS, or acquired immunodeficiency syndrome.
Durham County ranks fourth among the state’s 100 counties for the most people, about 2,000, living with HIV and fourth highest for AIDS cases, over 800.
“Folks who are homeless are much more likely to die with HIV,” Cunningham said, adding that more data is needed on this population. “Homelessness in Durham is rising in general, but we do not know how many of those folks are living with HIV.”
What are the needs?
People with HIV can become homeless when they get kicked out of their homes or are shunned by their families because of misinformation, Cunningham said.
In Durham, Black residents, who make up 37% of the population, account for 55% of HIV cases, according to Foster.
Latino residents, making up 14% of Durham’s population, have 19% of HIV cases. Recently incarcerated people also have a three to five times higher HIV risk, Foster said.
“It’s really important that 74% of people living with HIV in Durham are Black and Latino, in a city that celebrates health innovation,” Foster said. “We have a broken system and we have a lot of blocked pathways to services, so we want to really address the centralized intake process.”
Right now, in Durham and Durham County people who have HIV and are homeless arrive at one agency and are then referred to others before getting to a housing partner, Foster said.
Meanwhile, the Trump administration has proposed significant cuts to HIV and AIDS research and prevention programs. Last month, the state Department of Health and Human Services partnered with the NC AIDS Action Network to raise awareness that the cuts threaten progress in the state.
“Everything that we do around housing, it needs to be integrated and recognizing that we’re serving different populations,” Commissioner Wendy Jacobs said Tuesday.
“This is critical work here; we’ve got to get this right in Durham,” said Councilman Carl Rist.