Foundations in Community: HIV and Housing Research in Canada

At a Pacific AIDS Network staff meeting several weeks ago, we engaged in “gratitude practice” – taking the time to note what we were thankful for before we started discussing work. It had been cold and snowy for the first time this fall, and I shared that was grateful to be living in a cozy house with a wood stove.

As the study coordinator for Positive Living, Positive Homes (PLPH), I am reminded every day that I am fortunate not simply to have shelter, but to have shelter that is safe, structurally sound, and appropriate for my family. In this blog post – hopefully the first of many that I’ll write about the PLPH study – I’d like to take the opportunity to reflect on the nature, purpose, and direction of HIV and housing research in Canada, and on how PLPH fits into the national picture.

If you’re reading this, chances are you already know something about HIV and housing. Perhaps you’ve read this blog post by Christina Bielek, my predecessor in this role, which outlines the many reasons that being securely and appropriately housed is so important to people who are living with HIV. I won’t reiterate those here. What I will say is that the amount of research on housing and health seems to be increasing, and its nature seems to be more focused on community needs and processes: many HIV and housing studies are now true “community-based research” projects (CBR), which means that they begin with a research focus that a community – a particular group of people – identifies as important. From there, the group is involved in all phases of the research, from design, to data collection, to analysis, to translation of findings.

One important, recent example of community-based research (CBR) in Canada is Positive Spaces, Healthy Places (PSHP), which wrapped up in 2013. The first longitudinal CBR study in Canada, PSHP interviewed 502 participants over five years to examine the relationship between housing and the health of people living with HIV in Ontario. Here is just a small sample of PSHP findings:

  • Poor housing conditions, unsafe neighbourhoods, poverty, and HIV-related discrimination are among the highest concerns felt by HIV-positive parents (read more here);
  • Sixty-one per cent of Aboriginal participants had experienced homelessness at least once;
  • Twenty-two per cent of that 61% had been homeless three to five times;
  • Female Aboriginal participants were more likely than males to have experienced frequent homelessness (read more here) ; and,
  • Higher housing costs for those on low or fixed incomes can be a source of chronic stress, and impinge on the ability to pay for other items that increase health-related quality of life such as healthy food, recreation, and personal care.

Positive Spaces, Healthy Places formed the groundwork for Positive Living, Positive Homes. There has been no province-wide study to date on HIV and housing in BC, and PLPH will help to fill that gap.

Although PLPH will not run for as long as PSHP, it is community-based in the truest sense of the term. PLPH has been building relationships among and between people in HIV and housing service organizations at the local, regional, and national level since 2008, when the project was first conceptualized. These relationships have grown stronger over the years, and the almost 30 PLPH research team members (community consultants, community-based organization and government representatives, peer advisors, academics) work very well together. It’s sometimes said that the CBR process is just as important as the product: everyone on the PLPH team has learned something valuable from the others, and this learning will continue into the future.

If the nature of HIV and housing research is more community-oriented, it follows that the direction of such research is actionable and meaningful for the communities in question. CBR can take findings like the ones listed above and make them usable for the people who will benefit most. Because the initial research question comes from community, the findings can be more easily used by community.

Another aim of PLPH, then, is to increase the capacity of HIV-affected communities in BC. This will be done throughout the research process, by inviting team members (several of whom are HIV-positive) to engage in a variety of tasks, thus increasing our collective skill sets for research and collaboration.

QueIMG_6013 (806x1024)stions? Feedback? Get in touch!
ther Picotte
Coordinator, Positive Living, Positive Homes
[email protected]
Twitter: @PAN_CBR