HIV Homeless

HIV/AIDS & HOMELESSNESS
Recommendations for Clinical Practice and Public Policy

Developed for
The Bureau of Primary Health Care and
The HIV/AIDS Bureau
Health Resources and Services Administration by John Song, M.D., M.P.H., M.A.T.
November 1999

Financial and other support for the development and distribution of this paper were provided by the Bureau of Primary Health Care and the HIV/AIDS Bureau, Health Resources Services
Administration, United States Department of Health and Human Services, to the National
Health Care for the Homeless Council, Inc., and its subsidiary, the Health Care for the
Homeless Clinicians’ Network.
The views presented in this paper are those of the author and do not necessarily represent those of the United States government or of the National Health Care for the Homeless
Council.
Nothing in this paper should be construed as providing authoritative guidelines for the practice of medicine or for treatment of medical conditions.
This paper may be reproduced in whole or in part with appropriate recognition to the author,
John Y. Song, MD, and the publisher, the Health Care for the Homeless Clinicians’ Network,
National Health Care for the Homeless Council, Inc.
Second Printing
February, 2000

National Health Care for the Homeless Council
Health Care for the Homeless Clinicians’ Network
Post Office Box 60427
Nashville TN 37206-0427
Phone [phone]
Fax [phone] [e-mail] or [e-mail] http://www.nhchc.org i

PREFACE
HIV/AIDS and homelessness are twin plagues that take a staggering toll. Each condition complicates the other, and lives hang in the balance as health care providers and their patients try to sort through the complications and assure critical services. This paper is dedicated to the improvement of HIV/AIDS care for homeless people, and to the end of both of these plagues. In considering HIV/AIDS and homelessness together, this paper explores largely uncharted

References: Allen DM et al. HIV infection among homeless adults and runaway youth, United States, 1989-1992 AIDS Conference; Geneva, Switzerland: June 28-July 3, 1998. Abstract 32390. Bartlett JG. Medical Management of HIV Infection 1998. Baltimore, MD: Port City Press, 1998. Becker S. Adherence is not just for patients: Do clinicians follow treatment guidelines. Updates From Geneva, Healthcare Communications Group, L.L.C. 1998. Berry DE, McKinney MM, McClain M, Valero-Figueira E. Rural HIV Service Networks: Patterns of Care and Policy Issues. Rockville, MD: HRSA, 1995. Bluthenthal RN, Kral AH, et al. Use of an illegal syringe exchange and injection-related risk behaviors among street-recruited injection drug users in Oakland, California, 1992 to 1995. Phoenix, AZ: Oryx Press, 1996: 15-23. Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report, 10(2), Year-end Report, 1998. CDC. Surveillance of tuberculosis and AIDS co-morbidity – Florida, 1981-1993. MMWR