As HIV/AIDS Ravaged NYC, This Group Fought Back With Architecture

To understand how good housing can have a ripple effect across society, look no further than Housing Works.


When the Keith D. Cylar Community Health Center, a 36-unit residential building and medical clinic in New York’s East Village, opened in 1997, it was praised for its thoughtful–even luxurious–design. Samsung microwaves in every apartment, furniture from Steelcase and Crate & Barrel, and Ralph Lauren bedding. What made it unusual is that the residents were homeless and living with HIV/AIDS.


“I’ve lived in 18 different places, and they all reminded me of jail,” a resident, who remained anonymous, told the New York Times when it profiled the space. “Here, it feels like life, not death.”

The project was the first ground-up development from Housing Works, the New York-based nonprofit that, since its founding in 1990, has housed or served over 20,000 people who are homeless and living with HIV/AIDS. One of its core tenets? A home is more than four walls and a roof; it’s a powerful, essential healing force.

Housing Works History, a new online multimedia exhibition that launched this month, celebrates the organization’s legacy and impact. Gavin Browning–director of public programs at Columbia University, an architecture writer, and a curator–masterminded the project and treats it like a scrapbook, telling the story of the advocacy group through oral histories, archival ephemera, and architecture.

The organization is best known for its network of thrift stores and bookstores and has an active legal arm. In 2004, Housing Works sued an organization for refusing to house a transgender woman. When former NYC mayor Rudy Giuliani cut funding to Housing Works as a retaliation for the organization speaking out against his practices–Housing Works was the lead in a 1999 class-action lawsuit filed against the city for failing to provide adequate emergency housing for people with AIDS–Housing Works successfully sued in 2005 and received a $5 million settlement. One of its recent initiatives is the Asylum Project, which aims to help LGBT individuals from different countries who face violence based on their sexual orientation or identity.

But in Housing Works History, Browning chose to focus on Housing Works’s design legacy. “It’s a really tangible thing that they did–they built brick-and-mortar housing,” he says. “The results of civil disobedience and activism aren’t always obvious. These are actual structures.”


For the past 27 years, the organization has been a lifeline to, and advocate for, communities the city ignored and that mainstream society ostracized. Housing Works developed innovative housing models to serve its clients, many of whom have substance abuse problems, are people of color, or LGBTQ. Its ascribes to the model of Housing First, the name of an approach for homeless assistance that prioritizes housing above all else. First coined in the late 1980s in L.A., practitioners of Housing First try to get people into a residence as fast as possible and give them access to medical services, mental-health counseling, and drug-treatment programs. None of these programs are compulsory, and housing isn’t contingent on sobriety, which is often required to receive housing assistance. This approach is called Harm Reduction, a practice that attempt to reduce the negative impact of harmful activities. Needle exchanges–which aim to curb the rate of new HIV infections by reducing the use of old and shared needles–are an example of this policy.

While other nonprofits today focus on homelessness practice both Housing First and Harm Reduction approach–like the Skid Row Housing Trust in Los Angeles–Housing Works stands out for being an early adopter and for focusing on people with HIV/AIDS. “Housing First originated in the mental health field; we pioneered it in the HIV and chronic disease field,” Ginny Schubert, one of Housing Works’ founders, says.

When Housing Works started, most shelters in New York would not admit homeless drug users and required 30 days of sobriety. “Conditions in congregate shelters were dangerous to people with compromised immune systems and no one would take the clients we were working with, which were drug users,” Schubert says. “Harm reduction was an HIV reduction strategy. We believed, and were proven right, that access to housing was the way to begin a road to recovery rather than the reward for succeeding. It’s difficult to achieve any health outcome if you’re on the street. We always knew from the that we wanted Housing Works to be a low-threshold program that would help people regardless of their drug-use status.”

Today, all housing administered by the HIV/AIDS Services Administration–which provides emergency and temporary housing as well as other medical care and food assistance–are not allowed to restrict housing or services based on a person’s drug use status. This is a direct result of Housing Works’ success.

“Health care is housing,” Browning says. “You can’t get healthy unless you’re housed. For example, how can you stick to a pill regime if you don’t even have a bathroom?”


The Keith D. Cylar Community Health Center is just one of the housing types Housing Works has in its arsenal. Designed by Alan Wanzenberg, an architect known for luxury houses, the space was meticulously planned to offer services and housing in the same footprint without feeling institutional. For example, Wanzenberg made sure that the common dining area was located far away from counseling and treatment rooms to separate social activity from settings that can be emotionally painful. He also established plenty of sightlines throughout the space so the staff could keep watch over everything without having to resort to aggressive security.

Another important Housing Works project is transitional housing for women released from correctional facilities. Completed in 2007, the 20-unit Women’s Transitional Housing building by the architecture firm Archimuse is located in a renovated Brownstone in the Bed-Stuy neighborhood of Brooklyn. 100% of its residents achieve viral suppression–meaning that the amount of HIV in a person’s blood stream is very low because of taking medication regularly and as prescribed, a habit that is made possible through stable housing. (Housing Works believes that if someone doesn’t have a home, a lack of privacy to take their medicine or not having a place to store their medication will prevent them from sticking to a regimen.) Moreover, Housing Works provides meals, counseling, and transportation to offer consistency and routine in their clients’ lives. “That shows that housing is really a part of health care, social connections are part of health care, and you need stability for health,” Browning says.

While Housing Works owns some of its residences–like the Cylar Center and Women’s Transitional Housing–it also maintains leases on individual apartments scattered throughout the city. The Transgender Transitional Housing Program, for example, is composed of over 20 apartments in the East New York, Bushwick, Bed-Stuy, Crown Heights, and East Flatbush areas of Brooklyn. In a video about the program, Lynn Walker, managing director of housing programs and property management, explains that residents like the units because they have kitchens and a bathroom, and residents feel like they’re part of a typical residential setting, not a single-room-occupancy hotel, which is a common housing type for temporary and emergency homeless shelters. Additionally, they are all fully furnished with new products–the “welcome kit” has everything from brooms to blankets and utensils, which residents can take with them when they leave. The organization pays for this from its $43 million operating budget, which is funded in part by governmental and non-governmental donors and individual gifts; 25% comes from money earned from its thrift stores, bookstores, cafe, and catering company.

The larger narrative is about the power of non-governmental organizations to step in and provide short- and long-term solutions to public health problems. Housing Works fought for the people policy left behind and kept fighting to ensure policy caught up and government was held accountable. “Before the CDC expanded the definition of AIDS [in 1993 to include HIV], people with HIV couldn’t access services and medically appropriate,” he says. “It takes NGOs to find an immediate solution [for governmental gaps] and then influence a policy change to open up resources.”

Housing Works is currently working to end the AIDS epidemic across the United States with its Act Now, End AIDS and Undetectables program. While its true legacy and impact is still being developed, from a design standpoint it proved that architecture can be a healing force. “We demonstrated that a harm reduction approach to housing works for people–that’s our most important contribution,” Schubert says. “You don’t even need to have sobriety to live well and have good health outcomes.”


[All Images: via Housing Works]

About the author

Diana Budds is a New York–based writer covering design and the built environment.