Linking vulnerable drug using populations to quality care and services

Vulnerable populations include drug abusers, people living with HIV/AIDS, women sex traders, delinquent adolescents, and people marginalized by sexual preference (MSM, LGBT), race or language. The special needs of these groups are often not addressed within the healthcare system. Moreover, social injustices (e.g., racism and socioeconomic marginalization) often result in preventable health inequities. In their attempt to avoid stigma and discrimination, many of these vulnerable groups do not access and utilize needed care. Research identifies strategies for linking vulnerable groups to quality care and services and highlights public health implications. The first presentation emphasizes the need for strategic planning and understanding of the social context of communities so that efforts to link target population groups to available resources are successful. For example, PEPFAR provides funding for HIV testing and antiretroviral treatment in South Africa, but these efforts have had limited success in reaching drug users, particularly women who use drugs, many of whom are HIV+, largely because they were unaware of available care. Plans to reach and link this targeted population will be presented. The next presentation shares findings from a 5-year randomized intervention trial that tested two strengths-based case management approaches that were designed to increase health service linkages and reduce HIV risk among a sample of African American female sex traders. Preliminary analyses of follow up data show that a sizeable proportion of the sample did make linkages to care. The third presentation highlights effective strategies for linking and engaging delinquent adolescents who use drugs in family-based interventions.