Housing Insecurity and Perceived Mental Health Challenges Among Individuals Living with HIV: Qualitative Insights from Kisumu, Kenya

Introduction: HIV remains a public health concern despite several decades of effort. In sub-Saharan Africa, where political, environmental, and economic challenges persist, progress toward “Getting to Zero,” including zero new infections and zero HIV-related deaths, has been significantly slow. Although sub-Saharan Africa has seen the successful implementation of HIV/AIDS interventions across behavioral, biomedical, and structural approaches, there has been limited focus on housing insecurity—the inability to access safe, affordable, and stable housing—and mental health among people living with HIV, despite the critical role of housing insecurity in overall health and well-being. Therefore, this study explores how housing insecurity shapes mental health experiences among PLHIV in Kisumu. Methods: Using a qualitative approach, we purposively recruited 70 individuals from households participating in the Pamoja community-based organization’s Orphans and Vulnerable Children (OVC) project. We then conducted in-depth interviews (IDIs) with 30 participants and 4 focus group discussions (FGDs) with 40 adult participants living with HIV (ALHIV). Audio-recorded interviews were transcribed verbatim, translated from Luo into English, and uploaded to Atlas.TI v.23, a qualitative data analysis software. We then performed thematic analysis guided by grounded theory. Results: Our findings showed that housing insecurity was a significant issue for individuals living with HIV. The majority of participants experienced heightened feelings of worry, shame, fear, anxiety, stress, and depression, which negatively impacted their adherence to HIV treatment and care. While some participants showed resilience through acceptance and disclosure, limited resources and ongoing insecurity heightened vulnerability to mental health issues. Discussions: These findings underscore the importance of housing in HIV care programs and offer valuable insights for practitioners and policymakers. The findings highlight the need to incorporate housing stability and mental health support into HIV programs.