Understanding the pervasiveness of trauma within a housing facility for people living with HIV

Abstract

Trauma exposure is highly prevalent among marginalized people living with HIV (PLHIV). Trauma influences experiences in environments where PLHIV reside and access support services, in addition to impacting mental and physical health. This qualitative study of 24 PLHIV examined how trauma and socio-structural inequities shaped participants’ experiences living in a supportive housing facility for PLHIV, impacted health-related outcomes, and affected engagement in services. Participant narratives highlighted the frequency of traumatic experiences, which were often related to participants’ social locations (e.g., gender, race, and ethnicity). These experiences complicated how participants engaged with other residents and accessed support services within the housing facility. Participants reported self-isolation as a mechanism to avoid re-traumatization through interactions within the building, and to work towards attainment of what they viewed to be a ‘normal’ life. Supportive housing facilities that incorporate trauma-informed practices have the potential to attenuate the negative impacts of social marginalization within housing environments.

Keywords:

• Supportive housing
• HIV/AIDS
• trauma-informed
• structural vulnerability
• qualitative

Acknowledgments

The authors thank all those who contributed their time and expertise to this project, including participants, peer research associates, and the research team. They also extend their gratitude to the staff and board members of the housing facility. Finally, they thank Allison Enjetti and Ryan McNeil for their assistance with early formulations of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by an operating grant from the Canadian Institutes of Health Research (CIHR) [Grant Number: 201212] and Alexandra B. Collins is supported by a Vanier Canada Graduate Scholarship.

Notes on contributors

Katrina Koehn

Katrina Koehn is a student researcher at the BC Centre for Excellence in HIV/AIDS. She studies aging, housing, and food insecurity and serves on the board of directors for the YouthCO HIV and HepC non-profit society. (Source: https://sites.google.com/view/katrinakoehn/home)

Alexandra B. Collins

Alexandra B. Collins is a Research Associate with the BC Centre on Substance Use and a PhD Candidate in the Faculty of Health Sciences at Simon Fraser University (SFU). Her doctoral research explores the the impact of overlapping housing and overdose crises on overdose vulnerability for marginally housed women who use drugs in Vancouver, Canada. Her doctoral work is supported by a Vanier Canada Graduate Scholarship.

Heather Burgess

Heather Burgess is a graduate of UBC's School of Population and Public Health MPH program. She has a history of front-line work in public health initiatives in Vancouver’s Downtown Eastside and is interested in health care seeking behaviour among marginalized populations, the intersection of mental health and HIV risk, and peer engagement and community-based participatory research. She is now a research coordinator at the BC Centre for Excellence in HIV/AIDS.

Otto Von Bischoffshausen

Otto Von Bischoffshausen is a peer research associate at the BC Centre for Excellence in HIV/AIDS.

Megan Marziali

Megan Marziali has a BSc. in Microbiology and Immunology at the University of British Columbia and is starting her MPH at Columbia. She is a student researcher at the BC Centre for Excellence in HIV/AIDS involved in projects studying aging and housing. She is a strong advocate for community involvement in research, and serves on the board of directors for the Friends for Life non-profit society. (Source: https://www.vancouverfriendsforlife.ca/about)

Kate A. Salters

Kate A. Salters is a Lecturer with the Faculty of Health Sciences. Kate is also a Research Scientist with the Epidemiology and Population Health program at the BC Centre for Excellence in HIV/AIDS in Vancouver. Her research in the field of HIV/AIDS epidemiology focuses on issues related to reproductive health, chronic disease, and sexual health. She is a sexual health educator and a co-founder of the #LifeandlovewithHIV initiative, a partnership with SFU. (Source: https://www.sfu.ca/fhs/people/profiles/kas16.html)

Robert S. Hogg

Robert S. Hogg is a demographer with a masters in anthropology and has worked in the field of HIV/AIDS since 1995. He has established a national and international reputation in population health research that is based in community-engaged efforts to understand barriers to care and mortality outcomes among people living with HIV (PLHIV) marginalized by socio-structural inequities. He was recently appointed to the Order of Canada.

Surita Parashar

Surita Parashar is a Research Scientist at the BC Centre for Excellence in HIV/AIDS. Surita contributes to a number of studies within the Division of Epidemiology and Population Health including the Thrive Study, Dr. Peter Study, the Engage Study and the Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) project. (Source: http://cfenet.ubc.ca/about-us/team/parashar-s)