Advocates say affordable and stable housing is indispensable for homeless and low-income people living with HIV and AIDS, and that the city of Durham is failing to respond to this need.
The city is in charge of millions of dollars in federal funds from the Department of Housing and Urban Development designated specifically to help that community. The funds support the Housing Opportunities for Persons with AIDS (HOPWA) program, which provides rent and healthcare assistance.
The Coalition to End the HIV Epidemic in Durham - a group of community partners and Duke physicians - says obstacles like administrative deficiencies and staffing issues are blocking access to people from getting the care they need.
About 2,000 people in Durham live with the human immunodeficiency virus, known as HIV, and more than 800 people live with AIDS, the disease caused by HIV, according to the Department of Health and Human Services. The affected are disproportionately Black, Latino, and LGTBQ, according to the state.
There isn't good data collection on the exact number of affected Durham residents who are homeless or have unstable housing, according to the coalition.
The city is neglecting to act on an urgent matter, according to Hayley Cunningham, a Duke infectious diseases doctor who treats HIV patients and serves as co-chair of the coalition.
"Many Durham residents living with HIV are not getting appropriate treatment due to numerous barriers obstructing engagement in HIV care and medication adherence, including discrimination, stigma, and lack of transportation and affordable housing," Cunningham told the Durham City Council on Dec. 1.
Being homeless at the time of an HIV diagnosis is associated with increasingly higher odds of dying compared to those with stable housing, according to one National Institutes of Health study cited by Cunningham.
People must rely on HOPWA vouchers that are intended to be used in place of rent, but most landlords won't accept them because of rising housing costs and stigma of using them, according to Cunningham.
According to a city fiscal report, more than $1.3 million has gone unused as of this year in Durham for the federal AIDS housing program.
City officials had not responded to WUNC’s request for comment by Tuesday afternoon.
The city outsourced the allocation of HOPWA money to the Department of Social Services, which advocates say is inefficient and overwhelmed with existing service demand. Central Piedmont Community Action of NC (CPCA), the only other organization in charge of HOPWA in Durham, Orange, Chatham, and other counties, shut down earlier this year.
"I think the crisis going on is just a serious issue of neglect," said Lanea Foster, co-chair of the coalition and director of the Durham nonprofit Southeast Community Resources.
While the Coalition has counted on support from council members Carl Rist and Chelsea Cook, they say they've been met with indifference from the city. Mayor Leonardo Williams declined to sign a letter of support for the group to apply to a grant to administer HOPWA funds without much explanation, according to email correspondence sent to WUNC. In November, the coalition met with outgoing City Manager Wanda Page and other city officials without promising results.
"Durham and Chapel Hill are considered pretty progressive communities in general, but this particular group of people ... they're being completely ignored," Foster said.
The coalition says people with these diagnoses are struggling to find affordable housing near the Duke University Hospital system. Close proximity to doctors and care is particularly crucial for people living with AIDS, Foster said.
Durham County ranks 4th in the state for HIV prevalence, affecting nearly 2,000 people, according to the North Carolina Public Health.
