Advocacy

Ensuring all people living with HIV/AIDS and priority populations have a safe and affordable home and have full access to comprehensive health care.

National AIDS Housing Coalition (NAHC) is committed to ending the HIV/AIDS epidemic by ensuring that persons living with HIV/AIDS have quality, affordable, and appropriate housing by advocating for resources and equitable policies that guide this through our own efforts and supporting other Housing and HIV Advocate Organizations.

Fund HOPWA $750 million FY25

On April 10, 2023, 461 national, state, local organizations, and concerned citizens joined NHAHC to express our strong support to fund Housing Opportunities for Persons with AIDS (HOPWA) program at $600 million in the Fiscal Year 2024 (FY24) Transportation-HUD appropriations bill.

We are deeply concerned by the Biden Administration’s funding of HOPWA at $505 million. These funding levels do not match up with the increases of eligible clients in the HOPWA program, the rising cost of housing in the United States, and stagnant wages experienced by most and would result in thousands of extremely low-income people living with HIV/AIDS becoming homeless, thereby destabilizing the health of vulnerable individuals who have successfully obtained stable housing.  

In December 2022, NHAHC and the CDC published research in AIDS Journal, Needs for shelter or housing assistance among people with diagnosed HIV by jurisdiction: United States, 2015–2020’ in which found that nationally, only 1 in 4 (27.7%) PLWHA had shelter or housing service needs and among those who needed housing services, 2 in 5 (40.4%) did not receive them (range: 21.3% in New York to 62.3% in Georgia). The research also found that in 2019, HOPWA funding was only able to cover rent for all persons in need for 1.24 months. (range: 0.53 months in Virginia to 9.54 months in Puerto Rico).  

For over 30 years, HOPWA has provided a national safety net for very low-income people living with HIV/AIDS. The program provides competitive and formula grants to all fifty states, the District of Columbia, Puerto Rico, and the Virgin Islands. Through these grants, cities and states design and deliver stigma-free community-based, cost-effective housing and supportive services to people living with HIV/AIDS. HOPWA is critical because housing remains the greatest unmet need for people living with HIV/AIDS. Stable housing, like the housing provided by HOPWA grantees, leads to better health outcomes for those living with HIV. For people living with HIV, a better health outcome means viral suppression. An individual who is virally suppressed cannot transmit  the virus  to another person, thereby ensuring the health of their entire community.  

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Since the announcement of the Ending the HIV Epidemic: A Plan for America, leaders have acknowledged that the United States has the medical tools necessary to end the HIV Epidemic. However, research shows that we cannot end the HIV Epidemic without addressing the housing needs of individuals living with and at-risk of HIV/AIDS. Inadequate funding of the only federal housing program solely dedicated to addressing the housing needs of individuals with HIV/AIDS will be a barrier to the Ending the HIV Epidemic: A Plan for America initiative. 

HIV does not affect all Americans equally, making the need for adequate HOPWA funding in certain communities more important than ever.

  • 92% of HOPWA funds serve extremely-low to very-low-income households.
  • During the last program year, 46% of HOPWA funds assisted individuals in the 51+ age range. Currently, over half of adults living with HIV are over the age of 50, and by 2030 it is estimated that over 70% of those living with HIV in the United States will be 50+. 
  • Along with 8% of HOPWA’s homeless beneficiaries were veterans, an increase of 3% from the previous year, and another 52% were considered chronically homeless, which continues to increase each year.
  • 62% of HOPWA funds are serving the BIPOC community.
  • The program placed 19,777 new individuals into housing while providing housing for 45,740 households, provided 106,611 individuals with supportive services. 

If Congress and the President are serious about ending the HIV epidemic in America,  we implore you to fund HOPWA at least at $600 million for FY24. 

What NHAHC & Community Advocates have done so far

In 2022, the Biden administration released the National HIV/AIDS Strategy (NHAS) 2022-2025.  This strategy states that this will provide stakeholders across the nation with a roadmap to ‘accelerate efforts to end the HIV epidemic in the United States by 2030.’ It focuses on four main goals: 

  1. Prevent new HIV infections.
  2. Improve HIV-realted health outcomes of people with HIV.
  3. Reduce HIV-related disparities and health inequities.
  4. Achieve integrated, coordinated efforts that address the HIV epidemic among all partners and stakeholders.
What this strategy lacks is addressing the need for adequate, affordable, and quality housing. When 30% of PLWHA (persons living with HIV/AIDS) are housing insecure and 20% of those are homeless – achieving the first 3 goals of this strategy will be impossible. 

President Biden’s budget request proposes the HOPWA (Housing Opportunities for Persons Living with AIDS) program be funded at $505 million for fiscal year 2025. We are disappointed, as this is flat-funding from enacted FY24 levels. Due to inflation, it essentially cuts the HOPWA program– the only dedicated source of housing funds for people living with HIV/AIDS. Further, this proposed allocation doesn’t even touch the thousands of PLWHA on waiting lists for HOPWA. HUD’s justification also reports that HOPWA and other supportive housing programs for PLWHA is associated with a 41% reduction in emergency department visits and a 23% decrease in detectable viral loads.

 

History: In response to the unique and varied housing needs of people living with HIV/AIDS, the Housing Opportunities for Persons with AIDS (HOPWA) program was created in 1992. The program, housed in the Office of Community Planning and Development in the U.S. Department of Housing and Urban Development (HUD), directly addresses the housing and service needs of people living with HIV/AIDS. Research has shown that housing is the greatest unmet need for people living with the disease.

On December 29th, President Biden signed into law the FY 2023 omnibus appropriations bill. This was previously passed by the House on Friday December 23 with a 221-205-1 vote and a 68-29 Senate vote on December 22.

The bill allocates $499 million for HOPWA, a $49 million increase from FY22 and the highest level of funding in history. However, this amount is still far less than the $600 million we advocated for. Our advocacy will continue!

In addition— the nation will benefit from slight increases to other HIV programs and significant investments to other housing programs like Homeless Assistance Grants and Housing Choice Vouchers. Partners should be ready to pursue housing funding from a variety of streams in order to meet the needs of persons living with HIV/AIDS.

HOPWA Formula Update (Modernization): Prior to the HOPWA formula update, program funds were based on the number of cumulative AIDS cases since the epidemic began, including those who have died. Public Law 1114-201, the Housing Opportunity Through Modernization Act (HOMTA), signed into law in 2016, included the long-sought switch to count those living with HIV in a given jurisdiction rather than cumulative AIDS. Such distribution better reflects the nature of the HIV epidemic that has evolved over the years through advances in HIV care and surveillance and the increasingly disproportionate impact of HIV in communities of poverty. The update began phasing in the full implementation of the formula change over five years in FY17. It caps grantee gains at 10% and losses at 5% and includes a housing cost factor and poverty factor. FY21 reflects the full implementation of the HOPWA formula update.

HOPWA Funding History

HOPWA Funding 2010-2022

June 30, 2022: Appropriations Committee Approvals Fiscal Year 2023 Transportation, and Housing and Urban Development, and Related Agencies Funding Bill 

June 30, 2022: THUD FY23 Appropriations Bill

June 30, 2022: THUD FY23 Appropriations Report

We see this as a step to ending HIV/AIDS homelessness in the United States and demonstrates a commitment toward ending the HIV/AIDS epidemic in the United States.