Open Collections

Lehmann, Beatrix

University of British Columbia

Background: Eviction, generally defined as when individuals are forced to leave their home, is a severe form of housing need. However, little research has explored eviction among women living with HIV who may face intersecting barriers to stable housing. Drawing on frameworks related to intersectional stigma and discrimination, life course theories, and syndemic theory, the objectives of this thesis were to understand the prevalence and social-structural correlates of eviction, and associations between eviction and HIV-related syndemic outcomes. Methods: This thesis utilized data (2015-2023) from a community-based open cohort study of cis and trans women (14+ years old) living with and/or accessing HIV care in Metro Vancouver. Social-structural correlates hypothesized to be associated with eviction reflected systemic marginalization and stigmatization. Syndemic outcomes included: gender-based violence, depression, food insecurity and criminalized stimulant and opioid use. All variables, unless otherwise specified, referred to the previous six months before each study visit. Bivariate and multivariable logistic regression with generalized estimating equations (GEEs) were used to examine relationships between explanatory variables and binary outcomes; bivariate and multivariate ordinal logistic regression with GEEs were used in models with ordered outcomes. Results: Among 361 participants, the study sample had disproportionately high representations of Indigenous women (53.5%, n=193) and women with marginalized and minoritized sexual (47.4%, n=171) and gender (15.5%, n=56) identities, relative to the Canadian population. In multivariable logistic regression analysis using GEEs, being removed from parents as a child (adjusted odds ratio[aOR]: 2.11, 95% confidence interval [95%CI][1.13-3.92]) and criminalized substance use (aOR daily versus none: 3.87, 95%CI[1.44-10.44]; less than daily versus none: 2.79, 95%CI[1.03-7.57]) were significantly associated with increased odds of eviction. In multivariable logistic regression analysis with GEEs, eviction was significantly associated with depression (aOR: 2.07, 95%CI[1.15-3.74]). In multivariate ordinal regression analysis with GEEs, eviction was significantly associated with increased frequency of criminalized stimulant (aOR:2.56, 95%CI[1.26-5.16]) and opioid use (aOR: 2.03, 95%CI[1.03-4.03]). Conclusion: Prevention of eviction among women living with HIV must include systemic changes to housing policy and programs to support individuals at greater risk of eviction. A variety of affordable and/or supportive housing solutions are needed, incorporating culturally safe, trauma-informed, and gender-responsive approaches.

Thesis/Dissertation

eng

Vancouver : University of British Columbia Library

10.14288/1.0447414

Master of Science - MSc

Medicine, Faculty of; Population and Public Health (SPPH), School of

2025-05

Graduate

DSpace