{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:43:30Z","timestamp":1785437010173,"version":"3.56.0"},"reference-count":67,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000105","name":"York University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000105","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/05fq50484","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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 \u201cGetting to Zero,\u201d 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\u2014the inability to access safe, affordable, and stable housing\u2014and 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\u2019s 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.<\/jats:p>","DOI":"10.3390\/ijerph23050576","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:31:56Z","timestamp":1777465916000},"page":"576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Housing Insecurity and Perceived Mental Health Challenges Among Individuals Living with HIV: Qualitative Insights from Kisumu, Kenya"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4550-2667","authenticated-orcid":false,"given":"Patrick Mbullo","family":"Owuor","sequence":"first","affiliation":[{"name":"Department of Anthropology, Wayne State University, Detroit, MI 48202, USA"},{"name":"Pamoja Community-Based Organization, Kisumu 40100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Obondo","sequence":"additional","affiliation":[{"name":"Pamoja Community-Based Organization, Kisumu 40100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0878-2974","authenticated-orcid":false,"given":"Wicklife","family":"Orero","sequence":"additional","affiliation":[{"name":"Pamoja Community-Based Organization, Kisumu 40100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2970-1584","authenticated-orcid":false,"given":"Silvia","family":"Odhiambo","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyram","family":"Agbe","sequence":"additional","affiliation":[{"name":"Dahdaleh Institute for Global Health Research, York University, North York, ON M3J 1P3, Canada"},{"name":"Department of Geography and Environmental Studies, Carleton University, Ottawa, ON K1S 5B6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5898-6966","authenticated-orcid":false,"given":"Godfred","family":"Boateng","sequence":"additional","affiliation":[{"name":"Dahdaleh Institute for Global Health Research, York University, North York, ON M3J 1P3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2736-0108","authenticated-orcid":false,"given":"Elizabeth","family":"Onyango","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","unstructured":"WHO (2025, August 29). Housing and Health Guidelines. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241550376."},{"key":"ref_2","unstructured":"United Nations Human Settlements Programme (UN-Habitat) (2025, September 05). Rescuing SDG 11 for a Resilient Urban Planet. Nairobi. Available online: https:\/\/unhabitat.org\/sites\/default\/files\/2023\/11\/sdg_11_synthesis_report_2023_executive_summary_2023.pdf."},{"key":"ref_3","first-page":"40","article-title":"An analysis of the socio-economic antecedents of housing insecurity","volume":"10","author":"Dunga","year":"2018","journal-title":"Int. J. Econ. Financ. Stud."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Baker, S.R., Bloom, N., Davis, S.J., and Terry, S.J. (2020). COVID-Induced Economic Uncertainty, National Bureau of Economic Research. Available online: https:\/\/www.nber.org\/papers\/w26983.","DOI":"10.3386\/w26983"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1037\/ser0000164","article-title":"Homelessness as a public mental health and social problem: New knowledge and solutions","volume":"14","author":"Tsai","year":"2017","journal-title":"Psychol. Serv."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2105\/AJPH.2015.302905","article-title":"Housing Status, Medical Care, and Health Outcomes Among People Living with HIV\/AIDS: A Systematic Review","volume":"106","author":"Aidala","year":"2016","journal-title":"Am. J. Public Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"20646","DOI":"10.7448\/IAS.19.1.20646","article-title":"Structural drivers and social protection: Mechanisms of HIV risk and HIV prevention for South African adolescents","volume":"19","author":"Cluver","year":"2016","journal-title":"J. Int. AIDS Soc."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Owuor, P.M., Odhiambo, S.A., Orero, W.O., Owuor, J.A., and Onyango, E.O. (2025). Overcoming structural violence through community-based safe-spaces: Qualitative insights from young women on oral HIV pre-exposure prophylaxis (PrEP) in Kisumu, Kenya. PLoS Glob. Public Health, 5.","DOI":"10.1371\/journal.pgph.0004220"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s11904-015-0261-0","article-title":"Sustained High HIV Incidence in Young Women in Southern Africa: Social, Behavioral and Structural Factors and Emerging Intervention Approaches","volume":"12","author":"Harrison","year":"2015","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s43621-024-00645-0","article-title":"Sustainable development goals in Africa: Perspective from U.S. aid","volume":"5","author":"Yan","year":"2024","journal-title":"Discov. Sustain."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S0140-6736(05)71146-6","article-title":"Social determinants of health inequalities","volume":"365","author":"Marmot","year":"2005","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Buh, A., Deonandan, R., Gomes, J., Krentel, A., Oladimeji, O., and Yaya, S. (2022). Adherence barriers and interventions to improve ART adherence in Sub-Saharan African countries: A systematic review protocol. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0269252"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e449","DOI":"10.1016\/S2352-3018(25)00048-7","article-title":"The impact of homelessness and housing insecurity on HIV","volume":"12","author":"Dombrowski","year":"2025","journal-title":"Lancet HIV"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s12160-013-9559-6","article-title":"Depression treatment enhances adherence to antiretroviral therapy: A meta-analysis","volume":"47","author":"Sin","year":"2014","journal-title":"Ann. Behav. Med."},{"key":"ref_15","first-page":"100021","article-title":"Housing deprivation in rapidly urbanizing regions: Evidence from functional urban areas in Sub-Saharan Africa, South Asia, and Southeast Asia","volume":"4","author":"Granda","year":"2025","journal-title":"Glob. Chall. Reg. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e26245","DOI":"10.1002\/jia2.26245","article-title":"A sub-national HIV epidemic appraisal in Kenya: A new approach for identifying priority geographies, populations and programmes for optimizing coverage for HIV prevention","volume":"27","author":"Bhattacharjee","year":"2024","journal-title":"J. Int. AIDS Soc."},{"key":"ref_17","unstructured":"National AIDS and STI Control Programme (2018). Kenya Population-based HIV Impact Assessment, National AIDS and STI Control Programme (NASCOP). Available online: https:\/\/phia.icap.columbia.edu\/wp-content\/uploads\/2022\/08\/KENPHIA_Ago25-DIGITAL.pdf."},{"key":"ref_18","unstructured":"(2025, August 26). Kenya Health Metrics & Informatics Dashboard. Available online: https:\/\/analytics.nsdcc.go.ke\/."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Balakrishnan, A.K., Otieno, S., Dzombo, M., Plaxico, L., Ukoh, E., Obara, L.M., Brown, H., Musyimi, C., Lincoln, C., and Yang, L.S. (2024). Socio-ecological impacts of extreme weather events in two informal settlements in Nairobi, Kenya. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1389054"},{"key":"ref_20","unstructured":"Singer, M. (2009). Introduction to Syndemics: A Critical Systems Approach to Public and Community Health, John Wiley & Sons."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"113043","DOI":"10.1016\/j.socscimed.2020.113043","article-title":"The syndemic effects of food insecurity, water insecurity, and HIV on depressive symptomatology among Kenyan women","volume":"295","author":"Boateng","year":"2022","journal-title":"Soc. Sci. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Karbasi, A.B., Iloegbu, C., Ruan, C., Osei-Tutu, N., Patel, K., Frerichs, L., Patena, J., Vieira, D., Adenikinju, D., and Samuels, L. (2025). Syndemic interactions between HIV\/AIDS, mental health conditions, and non-communicable diseases in sub-Saharan Africa: A scoping review of contributing factors. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0328515"},{"key":"ref_23","first-page":"9124541","article-title":"Treatment Buddies Improve Clinic Attendance among Women but Not Men on Antiretroviral Therapy in the Nyanza Region of Kenya","volume":"2016","author":"Kibaara","year":"2016","journal-title":"AIDS Res. Treat."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1016\/S2352-3018(19)30343-1","article-title":"Stigma Reduction Interventions in People Living with HIV to Improve Health-Related Quality of Life","volume":"7","author":"Andersson","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13033-022-00527-w","article-title":"HIV related stigma associated with social support, alcohol use disorders, depression, anxiety, and suicidal ideation among people living with HIV: A systematic review and meta-analysis","volume":"16","author":"Armoon","year":"2022","journal-title":"Int. J. Ment. Health Syst."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e2201","DOI":"10.1002\/hsr2.2201","article-title":"Tuberculosis and HIV\/AIDS coinfection in patients attending Directly Observed Treatment Short-course (DOTS) centers in Anambra State, Nigeria: A retrospective study","volume":"7","author":"Okeke","year":"2024","journal-title":"Health Sci. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1309\/AJCP5XHDB1PNAEYT","article-title":"The Global Fight Against HIV\/AIDS, Tuberculosis, and Malaria: Current Status and Future Perspectives","volume":"131","author":"Vitoria","year":"2009","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"E26","DOI":"10.1016\/S2468-2667(16)30002-0","article-title":"Socioeconomic status and treatment outcomes for individuals with HIV on antiretroviral treatment in the UK: Cross-sectional and longitudinal analyses","volume":"1","author":"Burch","year":"2016","journal-title":"Lancet Public Health"},{"key":"ref_29","unstructured":"Odhiambo, S., Owuor, P., Obondo, D., Onyango, J., Kiplagat, J., and Onyango, E. (2025, April 06). No. 38: Informal Female Food Vendors, COVID-19, and Post-Pandemic Recovery in Kisumu, Kenya. Migration and Food Security (MiFOOD) Network. Available online: https:\/\/scholars.wlu.ca\/mifood\/28."},{"key":"ref_30","unstructured":"National Syndemic Disease Control Council\u2014NSDCC (2025, August 29). Available online: https:\/\/nsdcc.go.ke\/."},{"key":"ref_31","unstructured":"Creswell, J.W. (2014). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches, SAGE Publications. [4th ed.]."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/1098-240X(200006)23:3<246::AID-NUR9>3.0.CO;2-H","article-title":"Combining Qualitative and Quantitative Sampling, Data Collection, and Analysis Techniques in Mixed-Method Studies","volume":"23","author":"Sandelowski","year":"2000","journal-title":"Res. Nurs. Health"},{"key":"ref_33","unstructured":"Bernard, H.R. (2006). Research Methods in Anthropology: Qualitative and Quantitative Approaches, AltaMira Press. [4th ed.]."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1038\/s43586-022-00150-6","article-title":"Interviews in the social sciences","volume":"2","author":"Knott","year":"2022","journal-title":"Nat. Rev. Methods Primers"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1136\/bmj.311.7000.299","article-title":"Qualitative Research: Introducing focus groups","volume":"311","author":"Kitzinger","year":"1995","journal-title":"BMJ"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/2041-210X.12860","article-title":"The use of focus group discussion methodology: Insights from two decades of application in conservation","volume":"9","author":"Nyumba","year":"2018","journal-title":"Methods Ecol. Evol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e10645","DOI":"10.1002\/aet2.10645","article-title":"A practical guide for conducting qualitative research in medical education: Part 2\u2014Coding and thematic analysis","volume":"5","author":"Coates","year":"2021","journal-title":"AEM Educ. Train."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"214","DOI":"10.5014\/ajot.45.3.214","article-title":"Rigor in Qualitative Research: The Assessment of Trustworthiness","volume":"45","author":"Krefting","year":"1991","journal-title":"Am. J. Occup. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"100051","DOI":"10.1016\/j.glmedi.2024.100051","article-title":"The pillars of trustworthiness in qualitative research","volume":"2","author":"Ahmed","year":"2024","journal-title":"J. Med. Surg. Public Health"},{"key":"ref_40","first-page":"272","article-title":"Ensuring the Quality of the Findings of Qualitative Research: Looking at Trustworthiness Criteria","volume":"5","author":"Anney","year":"2018","journal-title":"J. Emerg. Trends Educ. Res. Policy Stud. (Jeteraps)"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s11135-021-01182-y","article-title":"A worked example of Braun and Clarke\u2019s approach to reflexive thematic analysis","volume":"56","author":"Byrne","year":"2022","journal-title":"Qual. Quant."},{"key":"ref_43","unstructured":"Assefa, W. (2015). An Assessment of Societal Outlook & Social Services for HIV\/AIDS Patients: The Case of Addis Ketema Subcity, Addis Ababa. [Master\u2019s Thesis, Gandhi National Open University (IGNOU)]. Available online: http:\/\/repository.smuc.edu.et\/handle\/123456789\/1232."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Knight, L., and Schatz, E. (2022). Social Support for Improved ART Adherence and Retention in Care among Older People Living with HIV in Urban South Africa: A Complex Balance between Disclosure and Stigma. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191811473"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Nabunya, P., Byansi, W., Sensoy Bahar, O., McKay, M., Ssewamala, F.M., and Damulira, C. (2020). Factors Associated With HIV Disclosure and HIV-Related Stigma Among Adolescents Living with HIV in Southwestern Uganda. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.00772"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.healthplace.2013.08.004","article-title":"Housing conditions and mental health of orphans in South Africa","volume":"24","author":"Marais","year":"2013","journal-title":"Health Place"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.socscimed.2004.12.018","article-title":"Psychological distress among AIDS orphans in rural Uganda","volume":"61","author":"Atwine","year":"2005","journal-title":"Soc. Sci. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/0956247813477809","article-title":"Cities through a \u201cgender lens\u201d: A golden \u201curban age\u201d for women in the global South?","volume":"25","author":"Chant","year":"2013","journal-title":"Environ. Urban."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Kiene, S.M., Lule, H., Sileo, K.M., Silmi, K.P., and Wanyenze, R.K. (2017). Depression, alcohol use, and intimate partner violence among outpatients in rural Uganda: Vulnerabilities for HIV, STIs and high risk sexual behavior. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-016-2162-2"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Dowdall, N., Ward, C.L., and Lund, C. (2017). The association between neighbourhood-level deprivation and depression: Evidence from the south african national income dynamics study. BMC Psychiatry, 17.","DOI":"10.1186\/s12888-017-1561-2"},{"key":"ref_51","first-page":"137","article-title":"A systematic review of relations between neighborhoods and mental health","volume":"9","author":"Truong","year":"2006","journal-title":"J. Ment. Health Policy Econ."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.ssmph.2016.04.003","article-title":"Food and housing insecurity and health status among U.S. adults with and without prior military service","volume":"2","author":"Schure","year":"2016","journal-title":"SSM-Popul. Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2489717","DOI":"10.1080\/17441692.2025.2489717","article-title":"Exploring the consequences of housing insecurity on HIV treatment outcomes: Qualitative insights from Kisumu, Kenya","volume":"20","author":"Owuor","year":"2025","journal-title":"Glob. Public Health"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e249","DOI":"10.1016\/S2352-3018(19)30433-3","article-title":"Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study","volume":"7","author":"Koss","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_55","first-page":"754","article-title":"Socio-cultural Factors in the Access of Women to HIV\/AIDS Prevention and Treatment Services in South-southern Nigeria","volume":"45","author":"Anugwom","year":"2016","journal-title":"Iran. J. Public Health"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Chimoyi, L., Chikovore, J., Musenge, E., Mabuto, T., Chetty-Makkan, C.M., Munyai, R., Nchachi, T., Charalambous, S., and Setswe, G. (2022). Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa. PLoS Glob. Public Health, 2.","DOI":"10.1371\/journal.pgph.0000132"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1521\/aeap.2013.25.3.216","article-title":"Jaboya vs. Jakambi: Status, Negotiation, and HIV Risks Among Female Migrants in the \u201cSex for Fish\u201d Economy in Nyanza Province, Kenya","volume":"25","author":"Camlin","year":"2013","journal-title":"AIDS Educ. Prev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0140-6736(14)60055-6","article-title":"Intimate partner violence and HIV: Unwelcome accomplices","volume":"383","author":"Cagney","year":"2014","journal-title":"Lancet"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1080\/09540121.2020.1770180","article-title":"Sleep and Immune Function Among People Living with Human Immunodeficiency Virus (HIV)","volume":"33","author":"Balthazar","year":"2021","journal-title":"AIDS Care"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"67","DOI":"10.5664\/jcsm.1666","article-title":"Types of Sleep Problems in Adults Living with HIV\/AIDS","volume":"8","author":"Lee","year":"2012","journal-title":"J. Clin. Sleep Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1037\/0033-2909.98.2.310","article-title":"Stress, social support, and the buffering hypothesis","volume":"98","author":"Cohen","year":"1985","journal-title":"Psychol. Bull."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Chan, C.Y., Lai, R.Y.S., Hoi, B., Li, M.Y.Y., Chan, J.H.Y., Sin, H.H.F., Chung, E.S.K., Cheung, R.T.Y., and Wong, E.L.Y. (2024). The effect of dwelling size on the mental health and quality of life of female caregivers living in informal tiny homes in Hong Kong. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-19915-7"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e32058","DOI":"10.1016\/j.heliyon.2024.e32058","article-title":"The influence of an agricultural intervention on social capital and water insecurity coping strategies: Qualitative evidence from female smallholder farmers living with HIV in western Kenya","volume":"10","author":"Owuor","year":"2024","journal-title":"Heliyon"},{"key":"ref_64","unstructured":"Garnham, L., and Rolfe, S. (2025, August 28). Housing as a Social Determinant of Health: Evidence from the Housing Through Social Enterprise Study. Available online: http:\/\/dspace.stir.ac.uk\/handle\/1893\/29377."},{"key":"ref_65","unstructured":"Mwega, F.M. (2009). A case study of aid effectiveness in kenya. Wolfensohn Center for Development Working Paper, Brookings."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1016\/j.socscimed.2006.05.012","article-title":"Syndemics, sex and the city: Understanding sexually transmitted diseases in social and cultural context","volume":"63","author":"Singer","year":"2006","journal-title":"Soc. Sci. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/0956247812438366","article-title":"Knowledge is power\u2014Informal communities assert their right to the city through SDI and community-led enumerations","volume":"24","author":"Patel","year":"2012","journal-title":"Environ. Urban."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/5\/576\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:14:16Z","timestamp":1777608856000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/5\/576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":67,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["ijerph23050576"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23050576","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]}}}