Safe living: the impact of unstable housing conditions on HIV risk reduction among female drug users

The objectives of this article are to explore differences in HIV risk behaviors and subsequent risk reduction among female drug users based on their housing conditions. In addition, we investigate psychosocial characteristics as mediators. Data were collected from 336 adult women. Structured interviews were conducted at baseline and at 6-month follow-up. At baseline, women with unstable housing conditions reported higher levels of HIV drug and sex-related HIV risk behavior. In addition, their levels of behavioral change over time were lower. The findings also show the importance of expanding the stable housing condition into two categories thereby distinguishing between a woman's own and someone else's place. None of the mediating factors were statistically significant and there was no moderation by intervention condition. The findings suggest that unstable housing conditions form a structural barrier to HIV risk reduction irrespective of the message. Future interventions should consider such conditions and the larger social context of the women's lives.