Power, social support and HIV-related service use: the roles of community and homelessness.

Abstract

Retrenchment of the Welfare State is often premised on the assumption that social support or community caring capacity can substitute for formal health and social services. We assert that the nature of this relationship depends on the nature of one's community. This paper examines social support and service use among gay and non-gay, homeless and domiciled people with HIV infection. In general, membership in the gay community is associated with greater use of formal services. Part of this relationship is explained, for homeless people, by one's level of access to social support. This suggests that, for this group, access to formal services can be improved by improving access to social support. Much of the relationship between membership in the gay community and use of services is not explained by social support and may be due to other factors such as the power of the gay community to create services for itself.