Yale University

Social Determinants of HIV: The Intersecting Impacts of Mass Incarceration, Housing Stability, and Subsidized Housing Policies

Funder: National Institute of Mental Health
Project period: 06/15/2016 - 03/31/2017
Grant Type: Research
Further Detail

Abstract Text:

This project will analyze three key, interrelated social determinants of HIV/AIDS and STIs-mass incarceration, housing stability, and subsidized housing policies -and the mechanisms through which they intersect to shape HIV-related sexual risk behaviors and race disparities in these behaviors. To date, research on the association between mass incarceration and HIV/AIDs and STIs has focused on incarceration's effects on relationship stability. Less attention has been paid to its effects on housing stabilityas a linking mechanism. Yet, extensive research has established housing stability as a social determinant of HIV/AIDS, though it rarely includes attention to mass incarceration. Nor has attention been paid to how policies that limit access to subsidized housing based on drug use and criminal history may impact on housing stability. At a time when subsidized housing increasingly represents the only available affordable housing option for the poor, such policies likely affect housing stability, not only among those directly involved with the criminal justice (CJ) system but among their loved ones as well. Thus, there is strong rationale to investigate the intersecting impacts of mass incarceration, housing stability, and subsidized housing policies on HIV/AIDS. Toward this end, this project has three specific aims: (1) To analyze variation across the US in the degree of restrictiveness of subsidized housing policies as it relates to rates of HIV/AIDS and STIs, and race disparities in these rates. This will be done through systematic coding of policies according to their degree of restrictiveness, and analysis of how policy variation is associated with disease rates; (2) To understand from the perspective of vulnerable populations how mass incarceration-including history of CJ involvement (personal, family, and sexual partner) and exposure to 'hyperpolicing"-housing stability, and experiences with subsidized housing policies intersect to impact HIV/AIDS/STI related sexual risks, and produce race disparities in these risks. This will be done through analysis of longitudinal qualitative and quantitative data collected from individuals recently involved in the CJ system and/or living in or seeking subsidized housing; and (3) To examine from the perspective of various stakeholders, including policymakers, program implementers, landlords, CJ personnel, and housing and legal service providers, how subsidized housing policies are interpreted and implemented locally and why they are interpreted and implemented in this way. This will be done through analysis of semi-structured interviews with these stakeholders.