Housing is harm reduction

Reddon et al.'s article [1] "Experiencing homelessness and progression through the HIV cascade of care among people who use drugs" describes findings from the first published longitudinal prospective study exploring relationships between homelessness and HIV care cascade outcomes in ACCESS, a Vancouver-based open cohort of people living with HIV (PWH) who use drugs.Consistent with the robust extant literature showing HIV disparities for unhoused PWH, this study found homelessness was associated with deleterious downstream outcomes across the HIV care cascade.Understanding how structural factors such as homelessness influence HIV outcomes is critical for developing interventions to reduce health disparities among people who use drugs (PWUD).The persistence of HIV-related health disparities by housing status even in Canada, which offers universal healthcare, is of great import for countries like the United States (US), where healthcare is more fragmented and beyond the reach of many, especially our unhoused.