Positive Spaces. Healthy Places.

An Ontario wide, community-based research study which aims to explore the intersections of

HIV, Housing and Health.

XVI International AIDS Conference in TorontoInnovations and Partnership to Improve Health Outcomes for People Living

with HIV/AIDS and Communities at Risk

Presented by Ruthann Tucker, Executive Director Fife House

August 16, 2006

Overview

Context The PartnersStudy ObjectivesProject OverviewCurrent StatusImplications forKnowledge TranslationFundersContact Info

Context

In 2002, at the Ontario AIDS Network (OAN) annual retreat for Executive Directors of AIDS Service Organizations participants overwhelmingly identified “housing issues” as a significant problem for PHAs across the province.

OAN receives Canadian Institutes of Health Research (CIHR) funding for a Research Technical Assistant

Context (2)

Proposed Strategy to Address HIV/AIDS in Ontario to 2008 identifies “housing as a key unmet need of PHAs”.

Fife House develops new strategic plan, 2003+ , that identifies community-based research as a priority for the agency to work on.

Context (3)

Key literature reviews indicate no information regarding this issue within the Canadian context.

Housing Connections, the agency the maintains the central wait list for social housing in Toronto, depriorizes HIV from the medical priority list in 2003.

PHAS must now get a Doctor to check a box that states the person has less than 2 years to live.

Context (4)

A small baseline study “Assessing the Housing Needs of PHAs Now and Into the Future” is funded by the OHTN.

The OHTN offers to assist study group to develop a proposal for submission to the CIHR for a grant to expand study to a more comprehensive 3 year study which includes both quantitative and qualitative methodologies.

Context (5)

CIHR funds 3 year study – “A prospective study to explore the impact of housing support and homelessness on health outcomes of PHAs”

Positive Spaces. Healthy Places. is created through the amalgamation of Assessing the Need (funded by the OHTN) and Exploring the Outcomes (funded by CIHR).

The Partners

Community-based AIDS Organizations

AIDS Thunder Bay – Michael Sobota, Co-Investigator AIDS Niagara – Steve Byers, Co-Investigator Bruce House - Jay J. Koornstra, Co-Investigator Fife House – Ruthann Tucker, Principle Investigator Ontario AIDS Network – Lea Narciso (on leave), Co-Investigator Ontario Aboriginal AIDS Network – Laverne Monette, Co-Investigator

Universities McMaster University, CLEAR Unit – Dr. Dale Guenter, Principle

Investigator York University, School of Social Work – Dr. Saara Greene, Principle

Investigator

Hospitals St Michaels Hospital, Centre for Research on Inner City Health - Drs.

Steven Hwang, Sean Rourke and Jim Dunn

Study Objectives

1. Establish a baseline of the housing status of PHAs in Ontario. 2. Identify the range of housing and supportive housing options

currently available to PHAs in Ontario.3. Identify the characteristics of appropriate housing and supportive

environments for PHAs applicable at various stages of the disease course.

4. Determine the kind of housing options desired or required by PHAs that will ensure access to health care, treatment and social services.

5. Identify the factors that affect the housing status and stability of PHAs; and to understand how such factors may impact the physical and mental health of PHAs and their access and utilization of health care, treatment and social services.

6. Determine possible variations in the housing and/or homelessness experiences of PHAs from specific communities.

Project Overview

600 face-to-face quantitative interviews with

PHAs from across Ontario within 4 regions(Northern, South West, Eastern and Central/Greater Toronto Area).

Participants will complete two face-to-face interviews across the study period, one at baseline and one at 12 months; and a short telephone survey at six months.

50 of whom will participate in a qualitative sub-study aimed at enhancing our understanding of the housing experiences of PHAs.

Regional epidemiology (R. Remis) used for study stratification.

Current Status

Research Coordinator Hired Dr. Amrita Ahluwalia

6 Peer Research Assistants Hired Participant Recruitment Underway (Baseline)

605 Calls/ 578 Eligible to Participate 535 Interviews Conducted

Challenges Reaching PHAs staying in shelter systems in all four regions Peer Research Assistant Turnover (30%) Central Region and Northern Region slower in meeting target

numbers

Implications forKnowledge Translation

The three (3) key areas for consideration1. Policy

CBR creates evidence which supports transformation of policy• Example Housing Connections – changes it’s

guidelines for assessing medical priority for people living with HIV/AIDS

Increase in units of affordable housing for PHAS Change policy for income support to make

maximum housing allowance more realistic for different regions in Ontario

Implications forKnowledge Translation (2)

2. Practice Identify what kind of housing PHAS want and/or

need; What health services PHAS want/need associated

with their housing; Provide useful data to support proposals for

additional funds to meet the need in regions in Ontario;

How CBAOs can partner with housing providers to develop strategies to keep PHAs housed;

Implications forKnowledge Translation (3)

3. Public Relations Educate the public about the issue of housing and

HIV in Ontario;• Example of this is the development of a web-based

housing portal for research on HIV, Housing and Health being developed by the OHTN and Fife House

Develop plain language Fact Sheets to be used by other communities to support the building of new housing;

Develop press releases to educate the public about the current context of HIV in Ontario and Canada;

Funders

Canadian Institutes of Health Research (CIHR) - $300,000

Ontario HIV Treatment Network (OHTN) - $170,000 + in-kind (office space, teleconference calls etc)

Ontario Ministry of Health and Long-term Care, AIDS Bureau - $35,000

Wellesley Central Health - $18,750 Ontario AIDS Network (OAN) - $6,600

Total = $530,350 over 3 years

Contact Info

Ruthann Tucker, Fife HouseCo-Principal Investigatorrtucker@fifehouse.org

416-205-9888x33Positive Spaces. Healthy Places

1-866-301-2548www.healthyhousing.ca