Saint Lucia: Housing for People Living With HIV/AIDS

The HIV/AIDS Epidemic

Saint Lucia is an island state located in the Eastern Caribbean. It is a primarily rural state with a population of 170,649. HIV/AIDS in Saint Lucia is a low-prevalence epidemic concentrated among sex workers (selling sex for money, drugs, gifts, and support) and men who have sex with men and women. According to Saint Lucia's 2010 Country Progress Report for UNGASS, "... trends in HIV transmission are linked to increased poverty and social disintegration with significantly higher levels of HIV now being identified in a number of vulnerable population groups." The feminization of the epidemic, in which the male: female ratio has gone from 75:25 to 58:42, is attributed to the underground population of men having sex with both men and women.

There are 450 known cases of living HIV/AIDS in Saint Lucia, which translates into a prevalence rate of 0.28%, but this number is likely to be a gross underestimation due to lack of adequate data and research on HIV prevalence among the drivers of the epidemic.

The Housing Crisis

Both the number of households and urbanization rates are increasing in Saint Lucia while average household size is declining. This means that more housing units will be required as rural to urban migration continues; 38% of the population now lives in urban areas. While housing quality has generally improved over time, housing disparities continue, and housing demand for both rental and owner-occupied housing far outstrips supply. Twenty-one percent of households live below the poverty line, and very low income groups cannot afford an average two-bedroom house at market value. Housing affordability is worsening overall, and rental housing is even less affordable than owner-occupied housing. Households living in poverty have responded to this crisis by erecting informal housing; there are at least 35 squatter settlements throughout Saint Lucia, and UN-Habitat estimates the slum to urban population ratio at 12%. The annual housing need over the next ten years is estimated at 2,100 units.

The Saint Lucia National Housing Corporation is the leading producer of low-income housing. However, low-income housing represents less than 30% of all housing production, even though 70% of housing applicants are classified as low income. Other programs and projects have provided housing targeted for low-income populations, but no comprehensive strategy exists for increasing low income housing stock.

"Special Needs Housing" for the elderly and homeless is usually sponsored by nongovernmental organizations and civil society organizations. The Caribbean Harm Reduction Coalition runs a shelter for HIV-positive drug users and MSM and provides outreach to homeless PLWHA to monitor medication and provide nutritional support, as well as performing general prevention and testing outreach to homeless crack cocaine users. In its recent survey of 350 homeless crack cocaine users, respondents indicated that the lack of housing stock is a major issue in obtaining affordable housing. According to the Coalition, 200 of the 450 PLWHA in Saint Lucia are either homelessness or living in unstable housing, but both funding and stigma, a not in my neighborhood mentality, are obstacles in providing housing support to this population.

Institutional Response & Solutions

In March of 2008 the Ministry of Housing, Urban Renewal and Local Government released its National Housing Policy, outlining the goals for housing development and strategies for achieving these objectives. In this document the government acknowledged the need for improved efficiency and collaboration among public and private organizations to improve housing delivery. One of the policy goals of this document is to "... promote sustainable mixed-income housing developments that meet the needs of all socio-economic groups and also takes cognizance of the needs of vulnerable groups." However, the Ministry of Housing, Urban Renewal and Local Government has not recognized the particular housing needs of PLWHA, despite the fact that UNAIDS recognizes the link between poverty, social disintegration, and HIV transmission rates.

According to the Caribbean Harm Reduction Coalition, more funding for housing programs for vulnerable populations would help solve the housing crisis for PLWHA.

The Saint Lucia National HIV and AIDS Strategic Plan has four broad strategies:

STRATEGY 1: Advocacy, Policy Development
Including advocacy, policy and legislation, poverty reduction, and human rights.
STRATEGY 2: Comprehensive HIV and AIDS care for all people living with HIV
Including treatment, care and support; guidelines and protocols; psychosocial care; stigma and discrimination; workplace interventions; and community and health systems interventions.
STRATEGY 3: Preventing further transmission of HIV
Including mother to child transmission, voluntary counseling and testing, and STI interventions among targeted and vulnerable groups.
STRATEGY 4: Strengthening national capacity to deliver an effective, coordinated and multi-sectoral response to the epidemic.
Including research and surveillance; monitoring and evaluation; empowering the National AIDS Coordinating Council; and multi-sectoral coordination and collaboration.

In addition to these strategies, a human rights desk was established in 2007 in order to deal with HIV/AIDS-related stigma and discrimination. Individuals can file complaints; the majority of complaints filed so far relate to stigma and discrimination within households and the community.

Advocate testimony provided by Bernard Frederick and Marcus Day of the Caribbean Harm Reduction Coalition.

Sources

Saint Lucia Ministry of Housing, Urban Renewal and Local Government, Saint Lucia National Housing Policy, 2008.

Saint Lucia Ministry of Physical Development, Environment and Housing, National Report on Housing and Resettlement in Saint Lucia, 2007.

UNGASS Country Progress Report: Saint Lucia, 2010.

UN-Habitat, Saint Lucia Statistical Overview, 2010.