Many of us can relate to John, a gay man who never believed he would live to see his 60's. John has been living with AIDS since the 80's and has been disabled due to his health for decades now. Until recently, he did not have access to employment that worked for his medical condition, so he has not been able to develop savings for retirement.
Confronting the loss of his long time companion, a German shepherd named Tom, John is living alone again. With an income of just $854 from Supplemental Security Income (SSI), John rents a room in a boarding house in an alley South of Market with barely any funds left over for food and other basic necessities.
John is not alone.
This is the experience of many, if not most, of the seniors and older adults living with HIV/AIDS in San Francisco.
By 2015 over half of all people living with HIV in the U.S. will be over age 50. A major reason for the "graying" of HIV in the U.S. is the tremendous success of medications that have dramatically increased the lifespans of people living with HIV, for which I, and many of my community members, are deeply and profoundly filled with gratitude.
While more people aging with HIV are living healthier, more productive lives than ever before, growing older with HIV presents multiple challenges. Because the immune systems of people living with HIV are constantly fighting infection, we are more prone to ongoing inflammation, which is linked to co-morbid conditions associated with aging such as diabetes, heart disease, hypertension, and cancer.
Liver disease, often the result of co-infection with hepatitis C, is prevalent. Decreased bone density is also common, potentially due to a combination of the normal aging process, medication side effects, and the direct effects of the virus itself.
In addition to these medical challenges, people with HIV/AIDS in San Francisco face a unique set of housing challenges due to the extremely high rents in relation to individual incomes. This is especially pronounced for HIVers living on a fixed income such as a retirement pension or Social Security Disability Income.
While San Francisco has invested in affordable housing, there are surprisingly few units of housing targeting people with HIV/AIDS, especially older adults. The federal Department of Housing and Urban Development has listed San Francisco in last place in the nation in terms of meeting the housing needs of people with HIV/AIDS.
Only 9.1 percent of people with HIV/AIDS are getting their housing needs met here. Clearly, there is room for increased effort.
This unmet housing need is highlighted every day in our work here at the AIDS Housing Alliance/SF. Of the members we serve who are 62 years of age or older, 26 percent are literally homeless, compared to 21 percent of the total population of our members.
The remainder is about to become homeless or is at-risk of homelessness. Sixty percent of people with HIV/AIDS will experience homelessness at least once during the course of their illness.
Some of this disproportionate rate of homelessness can be attributed to the additional housing barriers faced by the elderly, such as lack of mobility and cognitive decline. Another factor is the perceived stigma and discrimination faced by LGBT and HIV positive elders in accessing some senior housing programs.
Activists and community stakeholders recently won our struggle to create 110 units of senior housing at 55 Laguna - and to ensure that 100 percent of those units are affordable to the majority of LGBT seniors.
However, 110 units of housing for the entire LGBT senior community is a drop in the bucket compared to the need, especially for those of us with HIV who need to remain in San Francisco to maintain access to the highly specialized medical care that has allowed us to live this long.
The Housing Trust Fund recently passed by voters opens up the opportunity for the Mayor's Office of Housing to implement a Small Sites Acquisition Fund. The AIDS Housing Alliance/SF is committed to working with Mayor Ed Lee's administration, the Board of Supervisors and our sister agencies to use this fund to purchase a building that can be developed into a co-op targeting HIV positive older adults who are 55 years of age or older.
Cooperative housing is an alternate form of ownership in which the property is owned by an organization and then sold as shares to the residents of the community for a price that is affordable to them. This model provides for a remarkable sense of belonging, community, and safety. I feel it is just what the doctor ordered for many HIVers who are facing their "golden years."
Brian Basinger is the executive director of the AIDS Housing Alliance/SF.
For more information, and to be added to the invitation list to attend an upcoming HIV+ Elders Co-Op informational meeting, email [email protected].