The head of D.C.’s response to HIV conceded on Tuesday that city officials continue to grapple with the problem of a lack of housing for people with the virus.
“Housing is obviously a challenge that makes it more difficult for us to do what we need to do,” said Dr. Gregory Pappas of the Department of Health’s HIV/AIDS, Hepatitis, Sexually Transmitted Disease and Tuberculosis Administration. “Getting people to keep themselves safe, not getting infected, getting people to get tested, to get into treatment and stay in treatment is made more difficult when people are in a shelter.”
HAHSTA statistics indicate that 1,309 people in D.C., Northern Virginia and suburban Maryland have received subsidies through the Tenant-Based Rental Assistance program during this fiscal year that allows participants to obtain permanent affordable and quality housing in the private rental housing market through the federal Housing Opportunities for Persons with AIDS program. The agency distributes these funds through the metropolitan area and Jefferson County in the West Virginia panhandle.
Trenton Fedrick, manager of HAHSTA’s Housing Assistance Division, noted that some TBRA clients have been in the program for up to seven years, compared to an average of two years for those who receive transitional housing assistance. The agency’s own statistics indicate that 968 people with HIV remain on a waiting list to access housing-related assistance from the city.
Housing Works protesters heckled Mayor Vincent Gray on this point when he spoke at the International AIDS Conference at the Walter E. Washington Convention Center last month — the Blade spoke with one Southeast Washington resident with HIV who said he has been on a waiting list for access to housing for those with the virus since 2001.
Pappas acknowledged this backlog remains a problem. He stressed, however, that fewer than an estimated 20 of those on the waiting list are actually in homeless shelters or living on the streets.
“The waiting list is a bit contentious because people apply, but they can go on and have housing that we don’t know about,” he said. “It’s not like these people are all in the same situation. They apply and the number that’s kicked around is 1,000 people. What I don’t like is when people say 1,000 people are on the street. A thousand people have demonstrated need for some sort of support. Most of them like the rest of the housing problem in the United States and D.C. are staying with friends and relatives.”
Underlying socio-economic disparities and gentrification of traditionally lower-income neighborhoods also pose an ongoing challenge to securing housing for people with HIV.
Fedrick noted those with HIV who seek access to the city’s housing programs are unable to afford rents that average $1,400 a month for a one-bedroom apartment. Pappas further pointed out that many landlords are unwilling to rent apartments to those struggling with substance abuse and mental health issues.
“We’re talking about people who are not only HIV-positive, we’re talking about people who have socio-economic issues that put them in a situation where they are homeless,” added Fedrick. “You’re talking about people who have had in some ways a lifetime of issues, you’re talking about people who are in a position, at a point of time when our national economic issue is kind of dire with people being out of work. It’s not a simple fix. ”
Housing Works Director of National Organizing and Advocacy Larry Bryant agreed.
“The problem with HIV both here in the city and nationally is not just about people having unsafe sex,” he told the Blade. “It’s about people living in desperate situations, people who are on the edge of poverty or below poverty, people who are homeless. We’re not looking at it in a holistic kind of way.”
The city received roughly $8 million in HOPWA funds during this fiscal year for Tenant-Based Rental Assistance, the Short-Term Rental, Mortgage and Utility Assistance and transitional housing programs. Transgender Health Empowerment and Joseph’s House are among the local service providers that work with people with HIV who need housing assistance.
The U.S. Department of Housing and Urban Development in late 2009 threatened to cut $12.2 million in funding to the city over concerns that HAHSTA was not adequately tracking the use of HOPWA funds. Neither Pappas nor Fedrick were with the agency at the time of the audit, but they stressed to the Blade that HAHSTA has implemented a system of accountability that they maintain effectively monitors how local HIV/AIDS service providers use HOPWA funds it disseminates to them.
“We’re making sure that documentation of services are in place, that they’re providing services that are needed,” said Fedrick. “We’re taking a strong look at funds to see if there are places we can move funds or maybe we can move people off of waiting lists. We currently have providers who are providing good services and that aren’t stuck in issues of fraud, waste and abuse. I can’t speak to what happened then, but what’s happening now is a system of monitoring and mentoring with these programs so that our partnerships are stronger.”
Bryant said transparency remains a serious issue. He stressed, however, he remains equally concerned about what he described as the effectiveness of the funds used to address this problem.
“We have too many gaps where individuals who aren’t receiving housing and we’re not showing any long-term or even short-term improvement around how those housing dollars are benefitting, partly because we’re not sure that most entities know the importance [of] the relationship of safe and stable housing to an overall health outcome,” said Bryant. “Developing this comprehensive plan helps to ensure that any dollars used for housing, any dollars used for prevention and education is working together, working kind of across the board to help develop a stronger cohesive net to help improve all health outcomes.”