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The extent to which persons with human immunodeficiency virus (HIV) need housing assistance is not known, in part because the Department of Housing and Urban Development's (HUD) estimate of the housing needs of persons with HIV, including those with Acquired Immune Deficiency Syndrome (AIDS), is not reliable. HUD does not require Housing Opportunities for Persons with AIDS (HOPWA) grantees to use a consistent methodology to calculate unmet need. The agency has taken steps towards developing a standard methodology, but it has not established time frames for finalizing these efforts. GAO's work on assessing data reliability indicates that data should be consistent. Because HUD does not require grantees to use selected data sources in a consistent manner, the reported information on unmet housing needs of persons with HIV are not comparable across jurisdictions and are not useful and reliable. In addition, the statutory HOPWA funding formula is based on cumulative AIDS cases since 1981, including persons who have died, rather than on current numbers of persons living with HIV (including those with AIDS). This approach has led to areas with similar numbers of living HIV cases receiving different amounts of funding. Because HOPWA funds are awarded based on cumulative AIDS cases, these funds are not being targeted as effectively or equitably as they could be. Agency data for HOPWA and the Health Resources and Services Administration's (HRSA) Ryan White program indicate most recipients of assistance obtained stable, permanent housing, but Ryan White housing data may have limitations. HRSA, within the Department of Health and Human Services, does not require Ryan White grantees to maintain current data on clients' housing status. However, it uses the data that grantees report to calculate the proportion of clients that have stable housing. HRSA is charged with tracking Ryan White clients' housing status as a part of the White House's National HIV/AIDS Strategy. Federal internal control standards state that events should be promptly recorded to maintain their relevance and value to management in controlling operations and making decisions. Because HRSA does not require grantees to maintain current data on clients' housing status, HRSA's data may be of limited usefulness in tracking the National HIV/AIDS Strategy goal of improving clients' housing status.
Over 1.2 million people in the U.S. are estimated to have human immunodeficiency virus (HIV). Research has shown that persons with HIV who lack stable housing are less likely to adhere to HIV care. The Department of Housing and Urban Development's (HUD's) Housing Opportunities for Persons with AIDS (HOPWA) program and the Health Resources and Service's Administration's (HRSA's) Ryan White program provide grants to localities that can be used to fund housing and supportive services specifically for persons with HIV. This report addresses (1) the need for housing assistance for persons with HIV and the extent to which assistance reaches communities; (2) results achieved through HOPWA and Ryan White; and (3) federal oversight of these programs. Tables and figures. This is a print on demand report.
This book examines the structural dynamics of HIV among populations at heightened vulnerability to infection as the result of stigma, discrimination and marginalization. It first examines how the socio-structural context shapes HIV risk and how affected populations and national governments and programs have responded to these structural constraints. Chapters focus on structural determinants of HIV risk among transgender women in Guatemala, migrant workers in Mexico, Nigeria and Vietnam, and people who inject drugs in Tanzania. Next, the book examines resilience and community empowerment and mobilization among key populations such as female sex workers in the Dominican Republic and India, and young women and girls in Botswana, Malawi and Mozambique. A third set of chapters explores how national responses to HIV have addressed the role of structural factors in diverse political, geographic and epidemic settings including: Brazil, South Africa, Ukraine and the USA. Ultimately, effective and sustainable responses to HIV among marginalized groups must be grounded in an in-depth understanding of the factors that create vulnerability and risk and impede access to services. Throughout, this book brings together a rigorous social science research perspective with a strong rights-based approach to inform improvements in HIV programs and policies. It offers new insights into how to better address HIV and the health and human rights of historically excluded communities and groups.
" Over 1.2 million people in the United States are estimated to have HIV. Research has shown that persons with HIV who lack stable housing are less likely to adhere to HIV care. HUD's HOPWA program and HRSA's Ryan White program provide grants to localities that can be used to fund housing and supportive services specifically for persons with HIV. GAO was mandated to review housing assistance for persons with HIV. This report addresses (1) the need for housing assistance for persons with HIV and the extent to which assistance reaches communities, (2) results achieved through HOPWA and Ryan White, and (3) federal oversight of these programs. GAO analyzed program data as of 2012, reviewed policies, and visited a non-generalizable sample of four geographically diverse cities that received both HOPWA and Ryan White funding. "