Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108224

Pamela N. Klein, RN, MS and Carole A. Hohl, PA-C, MHS. HIV Services, Boston Health Care for the Homeless Program, 729 Massachusetts Avenue, Boston, MA 02118, 617-414-7771, pklein@bhchp.org

For homeless people with HIV, the chaos of daily life, competing life priorities such as finding food and shelter, mental illness and substance use dissuade many from seeking consistent medical care and compound the difficulties of adhering to complicated medical regimens and office visits. The HIV program at Boston Health Care for the Homeless Program attempts to address barriers by (1) utilizing a multidisciplinary health care team that meets patients in shelters, on the street, or wherever they stay, and (2) staffing a multidisciplinary clinic at an urban medical center to provide easy access for patients to receive HIV testing, primary care, specialty care, medication adherence support, nutrition services, mental health services and case management. Nurses and case managers form trusting relationships, engage patients in care and help them adhere to treatment. Patient comorbidities include hepatitis C (48%), substance abuse (64%) and mental illness (62%). Of 149 patients seen regularly by primary care clinicians in 2004, 68% were on potent antiretrovirals for their HIV disease. We will share our experience in providing primary HIV care to homeless people by describing our multidisciplinary team, quantifying patients' immunologic and virologic response to medications, and measuring their success in obtaining housing, maintaining primary care, and adhering to medications. We will show that with intensive case management, as well as a flexible multidisciplinary care team, homeless people can succeed in treatment for HIV.

Learning Objectives:

• List 3 barriers to health care that a homeless person infected with HIV may face.
• Describe how a multidisciplinary health care approach may help homeless HIV infected persons engage in care and adhere to medications.
• Explain why it is feasible and recommended that homeless people take potent HIV medications if medically necessary.

Keywords: HIV/AIDS, Homeless Health Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.