More than half of all new HIV diagnoses in the United States occur in the South. However, for many in this region, especially in cities like Atlanta, that diagnosis doesn’t occur in isolation. It intersects with another significant issue: homelessness or unstable housing. Despite decades of medical progress and well-intentioned public health campaigns, many strategies continue to overlook one of the most important indicators of long-term health: whether someone has a safe, stable place to live.

At Status: Home, we work with a population that is often not adequately addressed by traditional approaches. Atlanta’s homeless and low-income individuals and families are affected by HIV/AIDS. After over 35 years of working in this area, one observation remains consistent: housing is not just beneficial in the fight against HIV. It is a critical component. Yet, the intersection of HIV and housing is often underemphasized in public health discussions in the South.

Housing Is Healthcare — and the Research Supports It

There is significant evidence showing that housing is one of the strongest predictors of whether someone with HIV will access care and remain engaged in treatment. When people are stably housed, they are two to four times more likely to adhere to treatment and achieve viral suppression.

On the other hand, those experiencing homelessness while living with HIV are more likely to encounter difficulties such as increased hospitalizations, disruptions in care, or preventable health complications. The key difference isn’t necessarily access to medication; it’s the stability needed to take it consistently. Without housing, even the most advanced treatment plans can become ineffective. The body struggles to recover when it is in survival mode.

A Cost We Cannot Afford to Overlook

The personal toll is severe, but the public cost is also significant. When housing is absent from the care equation, we see higher emergency room visits, longer hospital stays, and avoidable deaths. The strain on public systems, ranging from healthcare to shelter services, grows over time, leading to increased costs and broader community impact.

It is often more expensive to manage the consequences of instability than to invest in providing safe, affordable housing from the outset. Housing, when treated as a form of healthcare, becomes one of the most effective and potentially cost-saving interventions available. However, it is still often treated as secondary or optional, something to consider after other needs have been addressed.

Building a Model That Works for the South

At Status: Home, we have learned that models developed in other cities do not always translate well to our region. The South faces unique challenges, from higher poverty rates to greater stigma, which require localized solutions. For this reason, we have spent years developing a program tailored specifically to Atlanta’s needs, integrating housing with healthcare access and long-term support.

In the past two years, we have purchased five multifamily properties, ensuring permanent affordability for our residents. We provide a continuum of housing options, ranging from emergency placements to long-term supportive housing, along with wraparound services such as case management, community engagement, and healthcare coordination. Although this work may not always make headlines, it has a substantial and positive impact on the lives of those we serve.

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The System Isn’t Broken — It Was Never Designed for This

The issue is not just a shortage of resources, but also the way systems were set up to function in isolation. Housing and healthcare systems were not originally designed to work together, and too often, they do not. Each operates according to its own set of rules, funding mechanisms, and definitions of success. For someone living with HIV, especially while dealing with poverty or homelessness, this disconnect isn’t just inefficient—it can create significant barriers to achieving stability.

This is not about completely overhauling existing systems, but rather about recognizing the need to better integrate them. We already have the necessary tools; what is required now is the collective will to connect them. This means recognizing housing as a fundamental form of healthcare, reassessing inflexible funding models, and creating policies that reflect the realities of those most affected, not just in medical terms but also socially, economically, and structurally.

Where We Go From Here

If we are serious about making progress in ending the HIV epidemic, particularly in the South, we must first ask the most basic question: Do people have a safe place to live? Without stable housing, many other health-related goals become increasingly difficult to achieve. Medication adherence, viral suppression, long-term wellness—all of these are deeply linked to the stability that housing provides.

We cannot afford to treat housing as an afterthought. It is not just a preventative measure but a form of ongoing care. It’s time for every health leader and policymaker to recognize what communities like ours have understood for years: we need more than just medication. We need safe and stable housing.

To truly address the HIV epidemic, particularly in the South, we must recognize that health begins at home. At Status: Home, we have spent decades showing that housing is not charity—it is care—and it is time for systems to reflect this truth.

Published by Anne C.