Uncovering patterns of HIV risk through multiple housing measures

Understanding the relationships between housing and HIV has been limited by reliance on a single housing indicator based on current living arrangements (e.g., stable, unstable, or homeless). This paper examines the cross-sectional and longitudinal relationships between five housing indicators (objective housing stability, subjective housing stability, supportive housing, number of residences in the last 6 months, and housing services needs) and four HIV risk behaviors (hard drug use, needle sharing, sex exchange, and unprotected intercourse) among women at-risk for HIV and with recent criminal justice system involvement (n = 493). In cross-sectional analyses, each risk behavior was associated with multiple indicators of poor housing, and the patterns of association varied by risk behavior. In the longitudinal analyses, changes in risk behavior were associated with changes in housing status since the previous assessment. These indicators reflect different aspects of housing and are uniquely associated with different risk behaviors. The relationships between housing and HIV risk are complex, and both constructs must be recognized as multidimensional.