Bus Tour Newsletter #27 – December 2022

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World AIDS Day takes place each year on Dec. 1 and International Day of People with Disabilities takes place each year on Dec. 3. This month’s newsletter covers the history of discrimination against Persons Living with HIV and AIDS (PLWHA) and protections for them under the FHA and Section 504 of the Rehabilitation Act of 1973, which protects individuals with physical impairments.

History of HIV/AIDS Discrimination

Throughout the 1980s and 1990s, there was widespread discrimination against communities who were most impacted by the HIV/AIDS epidemic, including gay men, African immigrants and refugees, and people of color. This stigma of the assumption of HIV/AIDS also extended to people who came from – or who looked like they came from – countries with high rates of HIV/AIDS infections.

In 1987, the 100th Congress introduced the AIDS Control Act to the Senate, which would have made HIV-positive status grounds for barring non-citizens from getting residency. That the bill was introduced by segregationist senator Jesse Helms only amplified the sense that the policy was specifically designed to target Haitians and sub-Saharan Africans. Although this legislation did not pass, the FDA later enacted a blood ban making it illegal for immigrants from Haiti and Africa to donate blood.

In 1990, thousands of Haitian Americans protested the FDA’s ban on blood donations, pointing out that this bill would open the floodgates to blatant discrimination against them. From 1990 to 1993, over 200 Haitians who had been granted asylum but tested positive for AIDS, or were related to someone who had, were detained in horrible conditions at Guantanamo Bay.

During that same time, reports of hate incidents against Haitians and Africans living in the United States exploded. There is ample evidence that discriminatory action at the government level gives legitimacy to bias crimes at the interpersonal level. President Reagan’s refusal to acknowledge AIDS until 1985 also gave credence to people who framed it as a moral failing among individuals rather than a public health issue. The stigma that governmental actions in the 1980s potentially caused even crept into national news as recently as 2018 when former President Trump was claimed to have said Haitians “all have AIDS.”

Rate of people living with HIV per 100,000 population in Oregon and the Pacific Northwest in 2020. (Source: Oregon – AIDSVu)

Housing is Healthcare for PLWHA

Between 1981 and 2021, HIV/AIDS killed more than 700,000 Americans, 4,613 of whom lived in Oregon. In recent years, officials have seen an HIV resurgence across the country. In 2020, there were 7,347 people living with HIV in Oregon and 180 people who were newly diagnosed with HIV.

The West Coast is extremely lacking in affordable housing for people who are sick or struggling with addiction compared to other regions. Multnomah County has seen a unique increase in HIV cases with a surge in outbreaks among intravenous drug users who are – or who soon become – homeless, and their sexual partners. Homeless PLWHA face the risk of having their medication stolen, lack clean shelter facilities, and suffer poor nutrition and sleep, which all make their immune systems more vulnerable to the disease.

There are many reasons why stable housing is particularly important for PLWHA, but a vital factor is the necessity for adequate healthcare. Housing is truly healthcare for PLWHA because with safe, decent, and affordable housing, people with HIV are better able to access medical care and supportive services, begin HIV treatment, take their HIV medication consistently, and see their health care provider regularly. HIV medication becomes ineffective over time if not taken consistently, and sometimes doctors will not even prescribe medication to HIV positive patients who do not have stable housing.

Studies show that people experiencing homelessness or housing instability have higher rates of HIV and mental health disorders than people with stable housing. Affordable and stable housing is not only healthcare, but studies also show it also acts as preventative care for PLWHA. The stigma of living with HIV/AIDS can be worse for people in rural areas who oftentimes may be forced to move due to housing instability. Moving from one home to another that is much further away distances them from their social support networks and the health services they need to survive.

Homeless with HIV: A lack of housing makes a preventable disease deadly in Oregon (Source: The Oregonian)

Federal Protections for PLWHA

In 1988, the Fair Housing Act was amended to include disability as a protected class, in part, to combat housing discrimination against PLWHA. This protection was added in the middle of the HIV/AIDS epidemic, when people were often discriminated against when seeking housing. Even if a person did not have HIV/AIDS but a housing provider assumed they were living with the disease, they would often still face housing discrimination.

There are several federal protections for PLWHA. HUD’s Office of HIV/AIDS Housing administers the Housing Opportunities for Persons with AIDS program. HUD also investigates complaints alleging violations of Section 504 of the Rehabilitation Act of 1973. Section 504 prohibits discrimination on the basis of disability in any program or activity that receives federal financial assistance from HUD or in programs conducted by HUD.

The Fair Housing Act and HUD’s Section 504 regulation define a person with a disability as:

A person with a physical or mental impairment which substantially limits one or more of that person’s major life activities;
A person who has a record of having such an impairment; or
A person who is regarded as having such an impairment.

PLWHA do not need to be symptomatic in order to file a complaint of discrimination under the FHA or Section 504. These laws also prohibit disability discrimination because a person has a record of having HIV/AIDS or is regarded as having the disease regardless of the accuracy of the record or belief of the discriminator. It is also important to note that housing discrimination based on HIV or AIDS can affect persons other than PLWHA. That is because if PLWHA are denied housing because of HIV/AIDS, their entire household can be affected and may also have a claim of discrimination under the FHA or Section 504.

Unfortunately, on average PLWHA are less likely to report housing discrimination when they experience it due to the stigma surrounding their HIV/AIDS status. Oftentimes, PLWHA are also living with other illnesses or disabilities, making the need for protections for this population even more important.

Resources for PLWHA

In 1983, grassroots organizers and LGBTQ community members in Oregon created Cascades AIDS Project (CAP) to provide crucial community services in the face of the HIV/AIDS epidemic. Since its creation, CAP has expanded to include educational outreach, legal advocacy, and primary health care for residents in Oregon and southern Washington. On Jan. 1, 2022, CAP merged with Our House, another grassroots nonprofit that was established in 1988 to provide housing and care for people with AIDS.

We want to hear from you

Is there a particular topic we discuss on the bus tour that you are interested in learning more about? Does your organization host events related to racial justice or other topics that come up on our bus tour? Email your events and ideas to information@fhco.org to have them included in our future newsletters.

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