“Poverty is undermining advances in HIV medicine.” That’s how Elise Riley, PhD, summed up her nearly 10 years of research on people living with HIV who struggle to have life’s most basic necessities. When people have no home to shelter them or food to fill their bellies, getting and taking HIV meds may not 
be a priority—or even a possibility.

Riley, of the Department of Medicine at the University of California at San Francisco, is the lead author on two recent studies that investigated the health of homeless people with HIV. One study looked at men; the other, women. Her findings? The heralded benefits of HIV meds don’t mean much for people who exist on society’s margins.

“While we found that viral load and adherence to medications were strong predictors of overall health status,” Riley told POZ, “unmet subsistence needs—access to sufficient housing, food, clothing and hygiene needs—had an even stronger influence [on the health of people living with the virus].”

To control the epidemic, Riley says, “We must ensure that stable housing and basic subsistence needs are met for all people with HIV.” It’s also cost-effective, she adds, as “housing assistance for homeless persons with HIV/AIDS reduces the use of costly emergency and inpatient health care services.”

The lesson? To end AIDS, we need to ensure that people with HIV have adequate housing, proper nutrition and access to HIV treatment.