Sydney, Australia: Housing for People Living With HIV/AIDS

The HIV/AIDS Epidemic

Sydney's HIV/AIDS epidemic is the largest and most concentrated in Australia. 2009 figures indicate a prevalence of 15,000 for the state of New South Wales. Incidence is declining in MSM and IDUs and increasing in women and aboriginal communities.

There is little difference in overall HIV/AIDS incidence rates between indigenous and nonindigenous people, but the method of HIV transmission differs significantly between these populations. Sexual contact between men accounted for 54% of HIV transmission in aboriginal communities and 67% of exposure in non-aboriginal communities. Heterosexual contact accounted for 23% of transmission in both the aboriginal and non-aboriginal communities. Injection drug use is higher among the aboriginal community (22%) than the non-aboriginal community (3%), while aboriginal women have a higher proportion of HIV infection (26.9%) than non-aboriginal women (11.6%).

The Housing Crisis

Estimates indicate that 1-3% of PLWHA in Sydney are either homeless or unstably housed. The main problem is the shrinking housing supply for PLWHA. Because housing need is greater than the supply, people with the most severe disabilities qualify for housing, which does not include PLWHA. There has been a bureaucratic shift since the late 1990s to reduce funding resources that support PLWHA. As PLWHA in Sydney, as a whole, are living longer and better, they are being forced to provide more for themselves, as evidenced in historical governmental funding streams. However, since funding has never been adequate, the reduction in funding places even more housing burden on PLWHA. Of course, stigma is always underlying.

PLWHA are more vulnerable to housing instability because once HIV is combined with another identity such as gender, cultural and linguistic difference, mental health issues, transactional sex, IDU, etc., there is a disproportionately large devastating effect. These social determinants of HIV health often lead to housing insecurity and need. For example, aboriginal PLWHA often have issues with unemployment, drug abuse and illiteracy, creating specific needs.

Institutional Response & Solutions

No institutions exist solely to address housing vulnerability for PLWHA. However, most of the HIV organizations are responsible for responding to the issue. New South Wales' Department of Health runs several housing facilities for PLWHA, while the main HIV-related NGO provides housing support and a welfare-style NGO provides social work assistance in the area.

According to the People Living with HIV Project, "there needs to be a shift toward increased funding for housing PLWHA. Decreasing the stigma associated with HIV/AIDS would improve the overall situation."

Advocate testimony provided by Barry Freedman of the People Living with HIV Project.