HOME Program: Cultivating Self-Sufficiency for Life
Chicago House has long known that stable housing is a crucial foundation for individuals to maintain good health while living with HIV. Since its launch in 2019, the HOME (Housing Opportunities Mean Everything) Program has exemplified just how effective stable housing can also be as a strategy for HIV prevention.
Conceived in partnership with the Chicago Department of Public Housing (CDPH), Chicago House launched HOME as an innovative housing program for HIV-negative Black and Latinx cisgender men who have sex with men (MSM). HOME falls somewhere between rapid rehousing and permanent supportive housing: participants enter the program with the goal of being able to “graduate” after 18 months. During that time, HOME participants have access to wraparound support services through Chicago House including employment support, pharmacy services, and connection to care coordinators, who can assist with setting up medical appointments and conducting HIV, syphilis, and hepatitis C testing. The overarching goals of the program are for participants to remain HIV-negative and to ultimately find sustainable employment and housing options that fit their needs and individual goals.
Some HOME participants reside in fully furnished two-bedroom apartments, with all utilities covered by Chicago House. Others—usually individuals who earn an income and have been in their current job for at least three months—live in rental assistance units and cover an increasing share of the rent each month until they can ultimately cover their rent in full. After leaving the program, former participants have access to six months of aftercare services.
HOME participants tend to be younger than the average Chicago House resident, with most between 18 and 25 years old. The vast majority of HOME participants reside on Chicago’s South side in neighborhoods disproportionately impacted by HIV, including community areas with some of the highest rates of new HIV cases in the city. Participants entering the HOME Program are unstably housed, which could include couch-surfing or staying with family members. In many ways, HOME prepares young people for self-sufficiency and the resilience needed to handle the challenges of adulthood. For example, HOME participants may share their apartment with a roommate, and learn to navigate the challenges and negotiation skills inherent in sharing a space with another person.
HOME also instills better impulse control and conflict resolution and reinforces the connection between stable employment and self-sufficiency. At this formative age, this can be a work in progress, explains HOME Program Manager Krista Sanders. “I had one client who was in a two-bedroom and moved into a one-bedroom, and he started working a little bit harder…to be able to pay for his portion of the rent and also continue to save money when he could. He really pushed himself to make sure he [could] do that. But I also had another client who, when I moved him into his own place, he quit his job the next day.” It can also be difficult to overcome a youthful sense of invincibility and instill that actions have consequences, especially when it comes to one’s health; for instance, deciding to discontinue PrEP (pre-exposure prophylaxis, a once-daily pill that protects against contracting HIV) without modifying other behaviors like increasing condom usage.
Even with these challenges, HOME has achieved overwhelming success. As for the program’s other key focus—empowering participants to remain HIV-negative—“nobody who has joined or left the program has seroconverted [become HIV positive],” Sanders reflects. “Even if they’re not staying on PrEP, I think the housing stability and the care coordinators having real conversations with them about prevention methods is the biggest thing.”
In total, four former HOME participants have graduated from the program and found their own sustainable living arrangements in their communities. The success of the HOME program illustrates the effectiveness of our housing-first model: safe, stable housing is key to achieving stability and self-sufficiency across all areas of life. Using a “housing as health” philosophy, HOME continues to prepare Black and Latinx young men for lives free from HIV.