Managing your health: a guide for people living with HIV
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Your housing is one of the keys to managing your health. It is as important as income, food and your treatment plan. Research studies like the community-based Positive Spaces, Healthy Places have shown that the type of housing you live in, the amount of money you spend each month for your housing, and how often you have to move directly affect your health when you are living with HIV.
Types of housing
Secure, stable housing provides a foundation for health and helps reduce the impact of HIV stigma and discrimination. People who have a stable place to live and the supports they need feel better physically and mentally, and are more likely to follow their treatment plan. Having a safe home has even been shown to help prevent HIV transmission.
In Canada, apart from home, condominium or apartment ownership, there are several different types of housing, including:
- private-market rental housing, which means renting a house, apartment or room from a landlord. The person or company that owns the apartment building or rental house determines the amount of rent charged. The landlord/owner is usually trying to make a profit from renting out the property, and will charge market rates;
- non-profit rental housing, which includes private non-profit and public non-profit (mainly operated by an independent organization funded by government). Non-profit housing operators usually charge just enough rent to cover the cost of running the building plus a bit extra in case the roof needs to be fixed or the building needs to be painted. Non-profit co-operatives, better known as co-ops, charge affordable but still market-rate rents. Co-operatives are regulated by the federal government and their own by-laws;
- social or subsidized housing is often funded by provincial or municipal governments and operated by an independent organization. Most social housing is “rent geared to income”: the amount of rent you pay is based on your income. Social housing is set aside for people who cannot afford to live in private-market or even non-profit housing. The social housing subsidy that the government provides may be linked to a particular unit in a specific building, which means a person has to live in that unit to receive the social housing subsidy; or, it may be connected to the person so he or she can take advantage of it wherever he or she lives (a portable subsidy). In some cases, co-operatives set aside a certain number of units for people living with HIV; in others, there are buildings dedicated for people with HIV, such as Fife House in Toronto, McLaren Housing in Vancouver or the Tommy Sexton Centre in St. John’s. Some communities have housing for people from specific populations, such as the housing programs for Aboriginal people in Vancouver;
- supportive housing or assisted living is housing plus support services provided by staff, such as helping people bathe, making their meals or helping with banking and grocery shopping. Supportive housing is usually available to people who have either a physical or mental disability and need support services as well as housing to live as independently as possible. Some communities have supportive housing specifically designated for people living with HIV;
- shelters or transitional housing provide temporary housing. Because there is such a shortage of affordable housing, many people with and without HIV live in a shelter at some point in their lives. Transitional housing is temporary: people stay for a fixed length of time until they find more permanent or stable housing.
Housing that meets your needs
The type of housing that you want and can find will depend on many factors, including cost, location, availability (some communities do not have social or supportive housing), your health needs and your preferences.
As you live with HIV over time and your needs change, you may need different types of housing. For example, HIV can make you unwell for periods of time. If you own your home or are paying market-rate rents, will you be able to afford the rent or mortgage if you are not able to work? Do you have the resources to see you through those periods? Think about more than the roof over your head. Look around your home or apartment. Will you be able to manage stairs? How wide are the hallways? Would a scooter fit through if you needed one in the future? It is important to take the time to think about how you can make your housing as secure and safe as possible, and get access to the supports you need.
Not every type of housing is for every person. Some people like to live in shared housing with roommates, while others want to have their own space. Some need supportive housing all the time and some only need support some of the time.
Some types of housing may have a negative impact on your health. For example, in a shelter you may be more likely to be exposed to tuberculosis.
It is important to think about the type of housing that best meets your needs.
How to access housing
Housing is one of the most urgent unmet needs facing people living with HIV in Canada. If you are living with HIV, you are probably living on a very tight budget. Most people with HIV live on a fixed income. This means you only have a certain amount to pay for your housing costs every month. If you are on a fixed income, it is important to assess your housing needs to ensure you have the best place you can afford, with the necessary supports in place to maintain your health.
Just as there are many types of housing, there are many ways to find or access housing. Looking for a place to live is like having a full-time job. It is work—hard work. You may get discouraged. Please remember that you are not alone and there are people who can help you find out about the housing in your area.
Some communities have housing help centres where a housing worker will help you through the maze of finding a place to live that is right or—in most cases—okay for you. The staff who work in these centres will know the rules and regulations about social or subsidized housing and supportive housing in your community; the rules change from province to province and municipality to municipality. Staff may be able to tell you if you qualify for subsidized housing based on your household income, and they will help you fill out the forms. It’s important for you to know that if you live with someone else, that person’s income is counted as well as yours to determine if you qualify for social or subsidized housing.
Some places have centralized waiting lists for subsidized housing; other places do not. There is usually a very, very long waiting list. But there may be a rule or regulation that gives people with HIV priority for subsidized housing. To get onto a waiting list or get priority for subsidized or supportive housing, people with HIV usually have to go through a process of having their health assessed. Your doctor may have to fill out a form—sometimes called a “medical priority”—and disclose information about your health. This may speed up the time you have to wait to find a place you can afford. You have to give your consent before your doctor can share any of your health information.
Some AIDS service organizations have staff, volunteers or peers—other people living with HIV—who are specifically trained to help you find a place to live.
Remember: if you are thinking about moving from one part of Canada to another or from one place to another, find out about the housing situation first. The availability, cost and quality of housing for people with HIV may vary greatly from one part of Canada to another.
How to keep your housing
Housing providers, landlords and shelters work within a set of rules that they have to follow, like turning the heat on by a certain time of the year and making repairs to rental units. People living in rental, social or supportive housing and in shelters are also expected to follow rules, such as paying the rent on time.
To keep your housing, you have to follow the rules. But you also have rights; landlords cannot evict you without cause. If you are about to lose your housing, it is important to know that there are services that can help.
- Housing workers can help you negotiate with your landlord and may even be able to help you keep your place.
- Legal services, such as legal aid clinics, can also help. Some are specifically designed to assist people living with HIV and some serve anyone who cannot afford a lawyer.
If your housing is at risk, do not wait until the last minute to get help. The sooner you seek assistance with your housing situation, the better the outcome will probably be.
It is also important to remember that you are part of the solution in finding and keeping a place to live.
The place you call home is more than an apartment or a room or a house. How you feel about where you live is very important in maintaining your overall health. In fact, if you are living with HIV, your housing is one of the foundations for health. If you have stable housing, you will be healthier, less stressed and enjoy a better quality of life. For more information on the types of housing and supports available and on how to find and keep affordable housing, contact your local AIDS organization, talk to other people living with HIV or look for resources on the Internet.
Positive Spaces, Healthy Places – A community-based research initiative to examine housing and health in the context of HIV
Healthy Housing – A site dedicated to providing information related to Housing and HIV/AIDS across Canada
Other relevant resources can be accessed through the CATIE Ordering Centre or by calling CATIE at 1-800-263-1638.