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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Anthony C. Tommasello, PhD, Office of Substance Abuse Studies, Univeristy of Maryland School of Pharmacy, 506 West Fayette Street, Century Building, Baltimore, MD 21201, 410 706 7513, atommase@rx.umaryland.edu, Jerry T. Lawler, PhD, Office of Substance Abuse Studies, University of Maryland School of Pharmacy, 506 West Fayette Street, Century Building, Baltimore, MD 21201, and Laura M. Gillis, MS, Health Care for the Homeless, 506 West Fayette Street, Century Building, Baltimore, MD 21201.
Homeless HIV infected persons with persistent mental illness and substance use disorders need services, are hard to reach, and difficult to engage in treatment. Servicing this group is among the most difficult challenges of the AIDS epidemic. Outreach to shelters and soup kitchens fails to capture them. They disappoint expectations of traditional service providers because subsistence needs trump medical concerns. We report street-based outreach to homeless, HIV-positive persons with substance use disorders and/or mental illness and their response to treatment in an integrated system of care. This HRSA/SPNS project conducted street outreach using an interdisciplinary team: addictions counselor, nurse, and formerly homeless person. Service needs were assessed using standardized instruments. Outreach clients (OR) were interviewed and their responses compared to a matched sample of clients who walked in (WI) for services at control clinics in the community. Subjects gave consent before being interviewed. Most (76.9%) had their own residence previously, but at enrollment only 11.4% of ORs and 12.7% of WIs had their own place. Others lived in shelters, on the streets, doubled up, or in drug programs. Median weeks in their current situation was 14.0 for ORs and 8.0 for WIs. About 50% were barred from housing services in the last 6 months. At 12-month follow-up, ORs showed a statistically significant increase in the proportion of clients obtaining their own place and a significant decrease of those in shelters. The WI group significantly increased the proportion acquiring their own residence with a non-significant decrease of clients in shelters.
Learning Objectives:
Keywords: Housing, HIV/AIDS
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.