Improving HIV viral load among homeless and unstably housed persons living with HIV/AIDS (PLWHA)

Issues: HIV/AIDS continues to impact millions of people worldwide. In the US alone, there are approximately 1.2 million people aged 13 and older living with HIV. Additionally, the incidence of HIV is quite alarming. Most recent CDC HIV surveillance data reports 48,100 new cases of HIV in 2009.

HIV disproportionately affects homeless populations. Despite efforts expended to develop services and programs to improve access to care for PLWHA, homelessness serves as a barrier to optimal utilization. Persons struggling with recurrent bouts of housing insecurity are more susceptible to HIV infections and behaviors that fuel the spread of HIV.

Description: Health Care for the Homeless recognized the need in Baltimore City for specialized services to address the comprehensive medical and social needs of PLWHA through its creation of the Connect Project. Dedicated to the provision of medically-related case management services than transcend the medical clinic, many services are provided in-home or at other community-based locations. In its efforts to improve housing and HIV-related health outcomes for participants, a team approach is utilized similar to those observed within the framework of a PCMH model.

Lessons Learned: Lessons learned includes knowledge that housing is health care. Individuals, when engaged through a comprehensive team approach, can realize housing stability and improved HIV health outcomes.

Recommendations: Despite the recognition that housing is positively associated with improvement in clinical health measures, housing options for the poor and homeless remain sparse. Increased collaborations between community-based agencies and housing entities, as well as enhanced funding, are desperately warranted.