Interdisciplinary, Community, and Peer Leadership Approach to Addressing Housing Among People Living With HIV in the Rural South

ABSTRACT

Housing remains the greatest unmet need for people living with HIV/AIDS (PLWH). Homelessness and unstable or marginal housing strongly predict poor health outcomes among PLWH, and they complicate the medical management of HIV. The majority of extant research has focused on urban areas; very few studies target areas in the rural South. Rural areas face distinct issues related to housing including a lack of structured housing programs. Further, the communal nature of life within the rural South presents an additional burden for PLWH as the disease is still highly stigmatized in these areas. The goal of this article is to: (a) describe issues related to housing needs among PLWH in the rural South and the effect of these factors on health outcomes; (b) highlight a community-based participatory research project, known as Project CHAP (Case management, Housing, Advocacy and Policy) and evaluate the impact of housing and case management on health outcomes among rural residents living with HIV in West Alabama; and (c) summarize the impact for future research or policy work in the area of housing among PLWH in the rural South. The findings have implications for PLWH and for those who provide care or services to this population.

KEYWORDS:

• HIV
• housing
• advocacy
• case management
• rural
• South

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Robert Wood Johnson Foundation.

Notes on contributors

Safiya George Dalmida

Safiya George Dalmida, PhD, is an associate professor at the University of Alabama’s Capstone College of Nursing. She received her training in nursing, HIV/AIDS, and religion and health from the University of the Virgin Islands, Emory University, and Duke University, respectively. She has expertise in conducting quantitative and qualitative sociobehavioral research in people living with or at risk for HIV/AIDS. She provides leadership on the health aspects of the project.

Wambui Muiga, BA, is a graduate student at the University of Alabama where she is pursuing an MA in school counseling. She works as a graduate assistant at the College of Education and Capstone College of Nursing, where she assists with different research projects, and gathering and organizing content for research. She has worked with Dr. George and her team on two projects, RuTelCo and Project CHAP, transcribing recordings and coding the transcriptions. She has also helped recruit participants over the phone, administer surveys, and extract and upload survey data to the Questionnaire Development Software warehouse.

George C. T. Mugoya

George C. T. Mugoya, PhD, is an assistant professor of counselor education. He received his training in biochemistry, rehabilitation counseling, and public health from the University of Nairobi, Bowling Green State University, and the University of Arizona, respectively. Originally from Kenya, he has lived in the United States for more than 10 years and in Alabama for the past 4 years. He has expertise in quantitative research and statistical methods and their applications in addition to counseling. He provides leadership in the implementation of data analysis and evaluation of project outcomes.

Billy Kirkpatrick

Billy Kirkpatrick, PhD, is the Executive Director of Five Horizons Health Services in Tuscaloosa, Alabama and an adjunct faculty member at the University of Alabama Department of Political Science. For 10 years, he has administered numerous programs designed to meet the holistic needs of individuals dually facing poverty and HIV infection. He has also designed HIV prevention, testing, and advocacy programs for college campuses and rural areas. He teaches courses related to nonprofit administration for graduate students.

Kyle Rhoads Kraemer

Kyle Rhoads Kraemer, MA, is a graduate research assistant for the University of Alabama’s Capstone College of Nursing, where he conducts data analysis and provides other contributions to a variety of research projects, including several related to HIV/AIDS research. He received training in biology and psychology from Centenary College of Louisiana, and in experimental psychology from the University of Alabama, where he currently studies as a doctoral candidate. He possesses expertise in human cognition, social motivation, and quantitative statistical analysis. He conducted an initial literature review for the project, and contributed to the writing and editing of this article.

Frenshai Bonner

Frenshai Bonner is Project CHAP’s Peer Leader extraordinaire. He has several years of experience working with people living with HIV, regarding HIV case management, HIV care, and recruitment for research studies. He also has been actively involved in helping to train people in various advocacy activities.

Jasmine Merritt

Jasmine Merritt, BS, is a recent graduate of the University of Alabama’s Public Health program. She works on Project CHAP as a research assistant and helps with participant recruitment, research interviews, transcription, and overall project management.

Pamela Payne Foster

Pamela Payne Foster, MD, MPH, is a contributing consultant. She received her MD from Meharry Medical College, her MPH from Columbia University, and preventive medicine residency training from State University of New York at Stony Brook. Her research area of expertise includes academic/community partnerships and HIV/AIDS-related stigma in faith-based settings in Black rural Southerners.

Jamie F. Satcher

Jamie F. Satcher, PhD, Project Coordinator, is a professor emeritus of counselor education at the University of Alabama where he also served as Associate Dean for Research and Service for the College of Education. His research background includes issues in counseling and counselor supervision, rehabilitation counseling practice, and attitudes toward gay men and lesbians. He is actively involved in addressing LGBTQ issues in counseling in Alabama. He recently published a short work of creative nonfiction, “Reckon He’s Queer?,” that was included in Older Queer Voices: The Intimacy of Survival—An Anthology. He was coaxed out of retirement to work with the research team for Project CHAP as study coordinator, and he is primarily responsible for recruiting participants and managing data collection.

Lauren B. Neal

Lauren B. Neal, MS, is a graduate student in the experimental psychology PhD program at the University of Alabama. She serves as a graduate research assistant at the Capstone College of Nursing and helped with data analysis and manuscript preparation and revisions.