Skip to main content

Advertisement

Log in

Under My Umbrella”: The housing experiences of HIV positive parents who live with and care for their children in Ontario

  • Original Contribution
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

Positive Spaces, Healthy Places (PSHP) is the first longitudinal community-based research (CBR) initiative in Canada to examine housing stability and its relationship to health related quality of life (HRQOL) for people living with of HIV/AIDS (PHAs). As part of our mixed method data collection strategy in-depth, semi-structured interviews were conducted with 50 PHAs across Ontario to provide a deeper understanding of the impact that housing instability has on their mental and physical health. Emerging from the qualitative interviews were the unique issues and concerns that were reported by parents who live with and care for their children. These parents face dire housing, economic and social challenges that are associated with significant risks for poor health outcomes. Poor housing conditions, unsafe neighborhoods, barriers to supports for themselves and their children, HIV related stigma, discrimination, racism, and poverty have been identified by these families as being among their most pressing concerns. This results in increased stress and anxiety that has a negative impact on the mental health of HIV positive parents. In order to more effectively support HIV positive parents and their children, health and social service practices and policies must respond to the unique challenges that face these families.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Aidala A, Cross JE, Stall R, Harre D, Sumartojo E (2005) Housing status and HIV risk behaviors: implications for prevention and policy. AIDS and Behavior 9:1–15

    Article  Google Scholar 

  • AIDS Bureau (2007) Building Bridges: an analysis and summary of the HIV/AIDS community planning initiative in Ontario, Ministry of Health and Long Term Care

  • Antle B, Wells L, Salter Goldie R, Matteo D, King S (2001) Challenges of parenting for families living with HIV/AIDS in. Social Work 46(2):159–169

    PubMed  CAS  Google Scholar 

  • Bryant T (2004) Housing and health. In: Raphael D (ed) Social determinants of health: Canadian perspectives. Toronto, ON, Canadian Scholars Press

  • Cheung AM, Hwang SW (2004) Risk of death among homeless women: a cohort study and review of the literature. Can Med Assoc J 170(8):1243–1247

    Article  Google Scholar 

  • Culhane DP, Gollub E, Kuhn R, Shpaner M (2001) The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilization in Philadelphia. J Epidemiol Community health 55:515–520

    Article  PubMed  CAS  Google Scholar 

  • DeMatteo D, Wells LM, Salter Goldie R, King SM (2002) The ‘family’ context of HIV: a need for comprehensive health and social policies. AIDS CARE 14(2):261–278

    Article  PubMed  CAS  Google Scholar 

  • Dunn JR (2000) Housing and health inequalities: review and prospects for research. Housing Studies 15(3):341–366

    Article  Google Scholar 

  • Dunn JR, Hays MV, Hulchanski D, Hwang SW, Potvin L (2004) Housing as a socio-economic determinant of health: a Canadian research framework. In: Howden-Chapman P, Carroll P (eds) Housing and health: research, policy and innovation. Steele Roberts, Wellington, pp 12–39

    Google Scholar 

  • Duran B, Butlerys M, Iralu J, Graham C, Edwards A, Harrison M (2000) American Indians with HIV/AIDS: health and social service needs, barriers to care, and satisfaction with services among a Western tribe. Am Indian Alsk Native Ment Health Res 9(2):22–36

    Google Scholar 

  • Enriquez M, Farnam R, Simpson K, Grantello S, Shandor MM. (2007). Pregnancy, poverty and HIV in, The Journal of Nurse Practitioners, pp.687–693

  • Fisher B, Hovell M, Hofstetter CR, Hough R (1995) Risks associated with long-term homelessness among women: battery, rape and HIV infection. Int J Health Serv 25:351–369

    PubMed  CAS  Google Scholar 

  • Frankish CJ, Hwang CW, Quantz D (2005) Homelessness and health in canada: lessons and priorities. Can J Public Health 96(Suppl 2):s23–s29

    PubMed  Google Scholar 

  • Geduld J, Gatali M, Remis R, Archibald CP (2003) Estimates of HIV prevalence and incidence in Canada. CCDR 2003 29:197–206

    CAS  Google Scholar 

  • Gielen AC, McDonnell KA, Burke JG, O’Campo P (2000) Women's lives after HIV positive diagnosis: disclosure and violence. Matern Child Health J 4(2):111–120

    Google Scholar 

  • Greene S, Tucker R, Rourke SB, Monet L, Sobota M, Koornstra J, Byers S, Hwang S, Dunn J, Guenter D (2007) Significant housing, economic and social challenges for people with HIV who are living with and caring for their children: result from the positive spaces, healthy places research study. NIMH Annual International Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, July 24–27th, San Francisco

  • Hwang SW (2001) Homelessness and health. Can Med Assoc J 164(2):229–233

    CAS  Google Scholar 

  • Ingram D, Hutchison S (1999) Defensive mothering in HIV positive mothers. Qual Health Res 9(2):243–258

    Google Scholar 

  • Kappel Ramji Consulting Group (2002) Common occurrence: the impact of homelessness on women’s health. Phase II: Community Based Action Research-Final Report, Toronto

  • Kilbourne A, Herndon B, Andersen RM, Wenzel SL, Gelberg L (2002) Psychiatric symptoms, health services, and HIV risk factors among homeless women. Journal of Health Care for the Poor and Underserved 13(1):49–65

    Article  PubMed  Google Scholar 

  • Kushel MB, Gupta R, Gee L, Hass JS (2006) Housing instability and food insecurity as barriers to health care among low income Americans. J Gen Intern Med 21(1):71–77

    Article  PubMed  Google Scholar 

  • Lawson E, Gardezi F, Calzavara L, Husbands W, Myers T, Tharao WE (2006) HIV/AIDS, stigma, denial, fear and discrimination: experiences and responses of people from African and Caribbean communities in Toronto. African and Caribbean Council on HIV/AIDS (ACCHO) and the HIV Social, Behavioral and Epidemiological Studies Unit, Department of Health Sciences, University of Toronto

  • Leaver CA, Bargh G, Dunn J, Hwang S (2007) The effects of housing status on health related outcomes in people living with HIV: a systematic review of the literature in. AIDS and Behavior 11(2):85–100

    Article  PubMed  Google Scholar 

  • Leserman J, Ironson G, O’Cleirigh C, Fordiani JM, Balbin B (2008) Stressful life events and adherence in HIV. AIDS Patient Care STDS 22(5):403–411

    Article  PubMed  Google Scholar 

  • Li A, Gillis L, Woolcott L, et al (2001) Improving access to legal services and health care for people with HIV/AIDS who are immigrants, refugees or without status in Canada. Toronto: Committee for Accessible AIDS Treatment

  • McGowan J, Shah S (2000) Prevention of perinatal HIV transmission during pregnancy. J Antimicrob Chemother 46:657–668

    Article  PubMed  CAS  Google Scholar 

  • McKeown I, Reid S, Turner S, Orr P (2002) Sexual violence and dislocation as social risk factors involved in the acquisition of HIV among women in Manitoba, The Prairie Women’s Health Centre of Excellence, Project #25

  • Murphy D (2006) FEANTSA, Prepared for the 2006 ENHR Conference, Workshop 5 “The Residential Context of Health” Brussels, June 2006

  • Nelson G, Sylevestre J, Aubry TJ, George L, Trainor J (2007) Housing choice and control, housing quality, and control over professional support as contributors to the subjective quality of life and community adaptation of people with severe mental illness. Adm Policy Ment Health 34(2):89–100

    Google Scholar 

  • Ontario Advisory Committee on HIV/AIDS (2002). A proposed HIV/AIDS Strategy for Ontario to 2008

  • Parish M, Burry C, Pabst MS (2003) Providing comprehensive case management to urban women with HIV/AIDS and their families in. Affilia 18:302

    Article  Google Scholar 

  • Peressini T, McDonald L (2000). Urban homelessness in Canada. In: Bunting T, Filion P (eds) Canadian cities in transition. Oxford University Press

  • Pequegnat W, Bray JH (1997) Families and HIV/AIDS: introduction to the special section. J Fam Psychol 11:3–10

    Article  Google Scholar 

  • Phelan JC, Link BG (1999) Who are the “homeless”? Reconsidering the stability and composition of the homeless population. Am J Public Health 89:1334–1338

    Google Scholar 

  • Remis RS (2006) Report on HIV/AIDS in Ontario

  • Remis RS, Swantee C, Schiedel L, Liu J (2008) Report on HIV/AIDS in Ontario 2006

  • Rotheram-Borus MJ, Weiss R, Alber S, Lester P (2005) Adolescent adjustment before nd after HIV-related parental death. J Consult Clin Psychol 73(2):221–228

    Article  PubMed  Google Scholar 

  • Salter Goldie R, De Matteo D, Wells L, Aykroyd G, King S (2000) Social planning in canada for families with HIV infection in. Can J Public Health 91(5):353–356

    Google Scholar 

  • Shelton D (1993) Issues related to health care utilization and medical adherence among prenatal HIV seropositive African-American women in Miami: the role of the family and the extended 50 kinship network. Fam Syst Med 11:1–14

    Article  Google Scholar 

  • Song J (2003) AIDS housing of Washington. AIDS Housing Survey, p.1

  • Stewart MJ, Neufeld A, Harrison MJ, Spitzer D, Hughes K, Makwarimba E (2006) Immigrant woman family caregivers in Canada: implications for policies and programmes in health and social sectors in. Health Soc Care Community 14(4):329–340

    Article  PubMed  CAS  Google Scholar 

  • Tischler V, Karim K, Rustall S, Gregory P, Vostanis P (2004) A family support service for homeless children and parents: users perspectives and characteristics in. Health Soc Care Community 12(4):327–335

    Article  PubMed  Google Scholar 

  • Tischler V, Rademeyer A, Vostanis P (2007) Mothers experiencing homelessness: mental health, support and social care needs in. Health Soc Care Community 15(3):246–253

    Article  PubMed  Google Scholar 

  • Tremblay J, Ward J (1998) Homeless voices: follow-up to the homeless, not helpless report. Toronto Health City Office, Toronto

    Google Scholar 

  • Waegemakers Schiff J (2007) Homeless families in Canada: discovering total families. Families in Society 88(1):131–140

    Google Scholar 

  • Weinreb L, Goldberg R, Lessard D, Perloff J, Bassuk E (1999) HIV-risk practices among homeless and low-income housed mothers. J Fam Pract 48:859–867

    PubMed  CAS  Google Scholar 

  • Wenzel SL, Tucker J, Elliot M, Hambarsoomian K (2007) Sexual risk among impoverished women: understanding the role of housing status. AIDS and Behavior 11(2):9–20

    Google Scholar 

  • Zierler S, Krieger N (2000) Social inequality and HIV infection in women. In: Mayer K, Pizer HF (eds) The emergence of AIDS: the impact on immunology, micorbiology and public health. American Public Health Association, Washington, DC

    Google Scholar 

Download references

Acknowledgements

We would like to acknowledge the Canadian Institute for Health Research, the Ontario HIV Treatment Network, the Wellesley Institute, and the AIDS Bureau for funding this study. We would also like to acknowledge the support of the participating community based AIDS Service organizations for their in-kind support and contribution to the research. This research highly benefitted from the ongoing contributions of the peer research assistants who have provided the team with priceless knowledge and expertise. Finally, we would like to thank the participants of this research for sharing their experiences with us.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Saara Greene.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Greene, S., Tucker, R., Rourke, S.B. et al.Under My Umbrella”: The housing experiences of HIV positive parents who live with and care for their children in Ontario. Arch Womens Ment Health 13, 223–232 (2010). https://doi.org/10.1007/s00737-009-0090-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-009-0090-5

Keywords

Navigation