Housing and HIV: HRSA and HUD Coordinate

Update of a 2020 Blog

People getting HIV medical care from HRSA's Ryan White HIV/AIDS Program (RWHAP) who have temporary or unstable housing continue to have the lowest percentages of viral suppression. However, improvements are being made, as evidenced by client-level data from the RWHAP over the 2010-2021 time frame.

• Among those with temporary housing, viral suppression increased from 63.7% to 83.6%.
• Among clients with unstable housing, viral suppression increased from 54.8% to 77.3%.
• Comparatively, viral suppression among clients with stable housing increased from 71.2% to 90.8%.

How Can RWHAP Support and Leverage Housing

Parts A-D can providing housing support services (see PCN 16-02). Examples of coordination and support may include: inclusion of housing services in planning processes and procurement; focus on housing for needs assessment studies; co-located housing and care services; targeted adherence programs for PWH experiencing unstable housing; inclusion of a housing indicator as a risk for non-adherence and/or medical retention; assessment of housing status as part of a care plan; resource commitment as appropriate; and enhanced strategic relationships with housing providers/experts.

HRSA and HUD Coordinate

HRSA's RWHAP has coordinated with federal housing programs for decades, particularly with the U.S. Department of Housing and Urban Development (HUD) HOPWA (Housing Opportunities for People with AIDS) program. 

• HOPWA and HOPWA Technical Assistance is designed to help grant recipients improve their operations to better deliver housing services to people with HIV.

HRSA TA Resources on HIV, Homelessness and Housing

Go to the Best Practices Compilation and search for strategies and interventions that have undergone HRSA review to document how they improve HIV outcomes in a "real world" setting and can be replicated by other programs.

Additional interventions, which may not have undergone Best Practices review to date, include:

• HHOME Homeless Health Outreach Mobile Engagement and KC Life 360: Employment-Focused Intervention to Link Clients to Support Services and Housing presents implementation guides and FAQs. (IHIP)
• Leveraging Housing Opportunities to Promote Retention in Care for People with HIV reviews rental assistance, housing placement assistance, or supportive permanent housing for low-income persons with HIV. (CIE)
• Sharing and Integrating HIV Client Data Across Provider Organizations to Improve Service Coordination is a toolkit for agencies seeking to integrate their data systems across housing and HIV care systems in order to improve service delivery. 
• The HIV, Housing & Employment Project is examining interventions that coordinate HIV care and treatment, housing, and employment services. Tools to date include webinars and project summaries.
• Building Medical Homes for Multiply Diagnosed HIV-Positive Homeless Populations features care coordinator/patient navigation interventions for vulnerable populations.

New in 2022: Supporting Replication (SURE) of Housing Interventions in the RWHAP