The Importance of a Sociological Perspective: The Food & Housing Insecurity of People Living with HIV/AIDS

Project Independence - A Way To Increase Food Insecurity Amongst a Vulnerable Population

I am a sociology major at SUNY Potsdam and was enrolled in senior seminar this semester in which I designed a research project that relates to public sociology in some way. I chose to design a study that will research how a rental subsidy program impacts the food insecurity faced by people living with HIV or AIDS (PLHIV) in the Tenderloin (a neighborhood located in San Francisco, California). A rental subsidy program is one in which participants receive a sum of money that supplements their rent payments each month. The rental subsidy program being evaluated in my research is called “Project Independence” and was originally implemented in Alameda County, California in 1997. It was evaluated by a team of researchers named Lisa Dasinger and Richard Speiglman in 2007. I decided to adapt their evaluation of Project Independence for use in my study by adding methodologies that would evaluate the impact of the rental subsidies provided on the food security faced by study participants. The hope is that food security increases as a result of increased housing security, and if food insecurity increases, then health may increase amongst PLHIV. The United Nations Subcommittee on Nutrition defines food insecurity as “‘the limited or uncertain availability of nutritionally adequate, safe foods or the inability to acquire personally acceptable foods in socially acceptable ways’” (Anema 2009:224-225). Researchers have defined stably housed or housing secure as living in a house or apartment or in a family members’ house or apartment. Whereas unstably housed or housing insecure has been defined as living in a single room occupancy hotel, shelter, “on the street,” in jail, or having no fixed address. A housing insecure state of living has also been defined as living in a single room occupancy building or living with a friend or sexual partner temporarily (Corneil 2006:2008; Convey 2011). Based on the results of Dasginer and Speiglman’s study, housing security of my study’s population pool would likely increase by virtue of the rental subsidy that will be provided to participants each month. The results of Dasinger and Speiglman’s study will be further discussed later on in this post.

The above research is of importance because scholars have found that food insecurity is widespread in San Francisco, California amongst housing insecure people living with HIV and has been linked to a person’s HIV status. It has also been found that more than 50% of housing insecure individuals living with HIV face food “insufficiency” as well as negative health effects (Bekele et al. 2015:1183). Below, I will discuss a political cartoon, which is a cultural representation relating to the food insecurity faced by PLHIV. This cultural representation does not contain a sociological perspective and I will discuss why it is important to maintain such a perspective. (A cultural representation is a product created by members of a society that depicts some aspect of culture. These representations can include news articles, art, and forms of media such as cartoons and memes.)

What is a Sociological Perspective?

According to C. Wright Mills, a prominent sociologist from the twentieth century, a sociological perspective involves being able to examine the different intersections that a person possesses and how they fit into the world at large in a historical sense. These intersections, also known as intersectionality, refer to the combination of one’s race, ethnicity, class, sexual orientation, gender, religion, age, disability status and other factors that impact one’s life experience in society. According to the philosopher Kimberle Crenshaw, these intersections are impacted by systems of oppression. A system of oppression refers to a harmful action, belief, policy, institution, or other entity that pervades society and oppresses or discriminates against a group of people based on their race, sexual orientation, gender, class, or other factor(s) tied to the intersectionality of one’s identity. For example, racism is a system of oppression. Racism is present in people’s harmful beliefs, prejudicial actions, policies, and in societal institutions. Intersectionality informs a sociological perspective by showing how these systems of oppression, discrimination, and domination lead to inequality in society. A sociological perspective examines how that inequality can be addressed by viewing society critically through a historical lens in order to understand the institutions in society (school, religion, family, law, etc.) that perpetuate these oppressive systems. An institution is a system of social organization that has been created with rules in place to govern people’s behavior. I will now discuss the meaning of the political cartoon below and what can be garnered when viewing it with a sociological perspective.

When a Sociological Perspective is Lacking



This political cartoon depicts a woman working in government food assistance, exclaiming to a bear, “sorry, we’re not allowed to feed the bears because you’ll become dependent and never learn to fend for yourself.” The portrait on the wall mocks Obama’s food assistance policies. The man standing behind the bear wearing a shirt displaying Obama’s campaign logo is portrayed to be “alternative,” signified by his spiked hair and gauge earrings. This portrayal of a person seeking assistance through Obama’s food stamp program may be intended to elicit a negative connotation surrounding individuals receiving food assistance. This cartoon sends the message that the government should not provide food assistance to “bears” or people who become dependent on government aid because they exploit welfare and “will never learn to fend for [themselves].” Therefore, this cartoon sends the message that unless a person is capable or only remaining on food for a period of time, they are not justified in receiving this form of welfare. This cartoon also sends the message that it is the fault of the “bears” or the individual for becoming “dependent” when in many cases, other sociological factors are responsible for why an individual may rely on welfare program such as food stamps. Therefore, this cartoon does not contain a sociological perspective.

What a Sociological Perspective Would Examine

A sociological perspective would examine why individuals who have sought out food assistance became “dependent” on it. It would take a closer look at the lives of each of these people based on the different intersections they each possess (race, ethnicity, class, sexual orientation, gender, religion, age, disability status). A sociological perspective varies from person to person based on these different factors and examines how each individual fits into society at large based on the systems of oppression that affect them as a result of these factors. For example, the disability status of a man living with HIV in San Francisco, California is a status involved in the intersectionality of his life that will negatively affect him by leading to decreased housing security, and therefore decreased food security and poorer health. All of these factors would contribute to his use of government food assistance programs. This is because researchers have found a strong link between high rent costs and food and housing insecurity amongst individuals living with HIV/AIDS in San Francisco. To further inform my argument regarding the sociological perspective this cartoon lacks, I will present some research regarding the food and housing insecurity that PLHIV face, and what factors have impacted these insecurities.

Why Food Assistance Amongst PLHIV is Justified 

According to researchers, food insecurity affects half of the population of poverty-stricken individuals in San Francisco living with HIV. Edward Frongillo and his team of researchers conducted a study in 2015 examining the lived effects and system-wide causes of food insecurity faced by low-income PLHIV in the San Francisco Bay Area. This study conducted thirty-four interviews with these individuals and found that a common cause of food insecurity was the combination of high rent payments and insufficient disability income. Gentrification refers to the process of a neighborhood developing, which leads to the increased value of properties and businesses, leading to the displacement and decreased economic status of that neighborhood’s native residents. The study also determined that those facing food insecurity experienced hunger from a lack of food, as well as lack of access to quality food, which created worries surrounding the health effects of a poor diet. Food was also acquired through socially unacceptable methods including extended reliance on family members, friends and charities for food, stealing, sex, and the illicit sale of controlled substances. Therefore, the factors preventing PLHIV from being able to afford food such as high rent payments and insufficient disability, justify their use of food stamps. In this study, the factors that acted as systems of oppression towards PLHIV include gentrification and insufficient disability income. It can be argued that these factors are forms of structural violence, which “[refer] to systematic ways in which social structures harm or otherwise disadvantage individuals” (Burtle).

The 2013 publication by Harder + Company, an organization that conducts community research, summarizes the barriers to food security that people living with HIV/AIDS face in San Francisco’s Tenderloin. Data states that over a third of residents make less than $15,000 a year and over 10% are unemployed. Researchers determined that the barriers to food security that people living with HIV/AIDS face in San Francisco’s Tenderloin include the fact that more than a quarter of residents living in the Tenderloin’s planning neighborhood use more than half of their income each month to pay rent. Therefore, authors determined that the high cost of living in the Tenderloin causes residents to face financial barriers when paying for rent, food, and medication. Other barriers include lack of food preparation facilities, an abundance of convenience stores offering unhealthy food options that take food stamps, a deficit of grocery stores offering healthy food options such as fresh produce, and a lack of nutritional and food preparation knowledge. This lack of healthy and affordable food choices has caused individuals to rely on programs and services for food. Authors state that cuts in spending on the federal level will also impact food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP) (originally known as the Food Stamp Program). Organizations are finding it more and more difficult to acquire grant money with which to provide individuals in need with assistance. Therefore, this compilation of research reveals that the factors preventing PLHIV from being able to afford food in the Tenderloin include financial barriers when paying for rent and medication, a lack of healthy food options, and a decrease in grant money. Cuts to SNAP funding will likely increase food insecurity amongst this population. Systems of oppression impacting PLHIV in the Tenderloin likely include gentrification, structural violence, and the stigma surrounding HIV and AIDS, though it is not directly stated in the publication that food insecurity in the Tenderloin can be attributed to these factors.

The Positive Effects of Project Independence - Increased Housing Security  

As discussed at the beginning of this post, Dasinger and Speiglman conducted a study in 2007 on the effects of the rent subsidy program, Project Independence, on low-income residents of Alameda County, California living with HIV/AIDS. Its objective was to take preventative measures against homelessness by providing rent subsidies to individuals in stable housing. The study measured how long 185 individuals remained in rental housing while satisfying the income requirement to remain in the program. The study measured these results against those of the comparison groups, composed of 218 people. After one year, 99% of PI participants were found to still be living in the subsidized rental housing provided by the program while only 32% of non-participants were still living in rental housing. After two years, 96% of PI participants were still living in rental housing while only 10% of non-participants were. Based on the research I have discussed in this post prior to this study, it has been made apparent that housing insecurity is heavily associated with food insecurity. Authors of the study suggest that future studies should be done to replicate this one, but in a context where there is a large disparity or gap between a large population of people living with HIV/AIDS in low-income households and affordable housing. Therefore, I have chosen to focus my research for this semester on the impact of Project Independence on low-income individuals with HIV/AIDS living in the Tenderloin to see how rental subsidies impact the food security of this population.

Final Thoughts

I hope this post has made it apparent why the cartoon discussed lacks a sociological perspective and why it is necessary to apply one. Frongillo and his team have suggested that measures be taken to address food insecurity at a structural level, incorporating interventions, rather than simply addressing the issue of food insecurity. These measures may include addressing urban policies conducive to gentrification and antiquated disability policies that hinder individuals’ means of subsistence. Authors of the publication released by Harder + Company recommend that steps be taken to: increase nutrition and food preparation knowledge amongst residents of the Tenderloin, increase the availability of food preparation facilities among homeless and single-room occupancy hotel residents, increase services available to older individuals and those with disabilities, and increase partnerships between agencies in order to combat food insecurity in the Tenderloin. Therefore, these are all factors that affect the food security of people living with HIV or AIDs in San Francisco and are reasons why I chose my specific research topic this semester.

References

Anema, Aranka, Edward A. Frongillo, Suneetha Kadiyala, Nicholas Vogenthaler, and Sheri D. 
Weiser. 2009. “Food Insecurity and HIV/AIDS: Current Knowledge, Gaps, and Research Priorities.” Current HIV/AIDS Reports 6(4): 224-231.

Bekele, Tsegaye, Stephanie K.Y. Choi, Sarah Fielden, Jason Globerman, Saara Greene, Keith 
Hambly, Stephen W. Hwang, J.J. Jay Koornstra, Doe O’Brien-Teengs, The Positive Spaces, Healthy Places Team, Sean B. Rourke, Michael Sobota, Ruthann Tucker, Glen Walker, and James Watson. 2015. “Food Insufficiency, Housing and Health-Related Quality of Life: Results from the Positive Spaces, Healthy Places Study.” AIDS Care 27(9): 1183-1190.

Burtle, Adam. “Structural Violence.” Structural Violence. Retrieved December 13, 2017 (http://www.structuralviolence.org/structural-violence/).

Convey, Mark, Julia Dickson-Gomez, Timothy McAuliffe, Jill Owczarak, and Margaret Weeks. 
2011. “Access to Housing Subsidies, Housing Status, Drug Use and HIV Risk Among Low-Income U.S. Urban Residents.” Substance Abuse, Treatment Prevention, and Policy 6: 31-42. 

Corneil, Trevor A., Robert S. Hogga, Laura M. Kuypera, Kathy Lia, Martin T. Schechtera, Jean Shovellerb, Patricia M. Spittala, Evan Wood. 2006. “Unstable Housing, Associated Risk Behaviour, and Increased Risk for HIV Infection Among Injection Drug Users.” Health Place, 12(1): 79-85.


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