Stable housing is consistently found to be the greatest unmet need of persons with HIV/AIDS reentering their community from prison, according to a joint report from the National Minority AIDS Council (NMAC) and Housing Works regarding the link between housing instability and HIV/AIDS treatment for incarcerated Americans. About 155,000 Americans living with HIV/AIDS (one in seven) are released from correctional facilities annually. Unstable housing can inhibit improvements in physical and mental health, result in the further spread of HIV, and increase incidences of emergency health care. The report calls for targeted housing and other measures to prevent the cyclical nature of incarceration and unsteady access to treatment for those living with HIV/AIDS. In correctional facilities, HIV/AIDS occurs in rates three to five times higher than that of the general population. Because access to HIV care is legally protected in correctional facilities, prisons and jails provide consistent HIV care that former inmates often lose with reentry into the community. A recent multisite study of HIV-positive men entering jail showed that 43% were newly diagnosed with HIV and 44% previously diagnosed men were homeless before they entered prison. Upon being discharged, a Connecticut study found that 26% of inmates with HIV/AIDS were homeless and an additional 54% were “near homeless” when released. Persons with HIV who lack stable housing are two to three times more likely to engage in sex exchange or unprotected sex with an unknown status partner, and use or inject drugs. Thus, rates of new HIV diagnoses have been as much as 16 times higher for homeless individuals than for those in the general population. Additionally, persons with HIV who lack stable housing are more likely to delay care, have limited access to care and are less likely to receive antiretroviral therapy. The NMAC report focuses on the disproportional rates of incarceration and HIV/AIDS occurrence by race and sex. Black Americans accounted for 46% of new HIV infections, 44% of people living with HIV and about half of new AIDS diagnoses in 2010. Additionally, the HIV infection rate among black women is 15 times that of white women. Imprisoned women have a higher HIV prevalence due to the risk of drug-related and sex work crimes that result in overall worse health problems than their male counterparts. The report provides a set of recommendations for improving housing and health outcomes, targeting formerly incarcerated individuals with HIV/AIDS. Large-scale studies find that housing assistance and health care yield positive health outcomes as well as cost saving for communities. The recommendations from NMAC and Housing Works include providing greater access to housing through targeting resources, removing barriers to income and insurance measures, improving pre-release discharge plans, and evaluating effectiveness of programs for formerly incarcerated people with HIV/AIDS. The report establishes the opportunity to stable and affordable housing as a primary factor in improving access to consistent treatment and limiting re-entry to prisons and jails.Click here for Mass Incarceration, Housing Instability and HIV/AIDS: Research Findings and Policy Recommendations (PDF).