The Homeless
It is estimated that as many as 3.5 million people are homeless over the course of a year. 3% report having HIV/AIDS, and 26% report acute health problems other than HIV/AIDS such as tuberculosis, pneumonia, or sexually transmitted diseases.1 Some studies indicate that the prevalence of HIV among homeless people is as high as 20%.2 Even higher prevalence rates (8.5% – 62%) have been reported in various homeless subpopulations, including adults with severe mental illness.3
Of the 400,000 to 600,000 individuals currently estimated to be living with AIDS in the United States, approximately one-third to one-half are either homeless or at imminent risk of homelessness. 4
According to the Health Care for the Homeless Clinicians' Network report, HIV and Homelessness: Recommendations for Clinical Practice and Public Policy: "Homelessness and HIV/AIDS are widespread and intersecting problems that occur in both urban and rural populations throughout the United States. Conditions associated with homelessness make HIV prevention and control especially difficult. Limited access to medical care severely restricts HIV/AIDS prevention, risk reduction, and treatment for homeless persons. Adherence to complex HIV treatment regimens presents special challenges for homeless patients and their caregivers. To address these critical public health issues, access to health care for homeless individuals must be increased through expanded health coverage. Better coordination of care must be achieved among providers of clinical and social services, which must include behavioral health care and housing. In addition, continuity of care must be improved, especially following admission to and discharge from inpatient and criminal justice facilities."5
Homelessness presents many barriers to healthcare. However, homeless persons can receive effective healthcare if it is delivered in the context of their usual life activities by professional providers who recognize and respect the autonomy of the individual patient and clearly communicate this respect to their patients to foster trust.
Featured Links
Best Practices in TB Control: Working with Substance Users and Homeless Populations
From the New Jersey Medical School Global Tuberculosis Institute
Shelters and TB: What Staff Need to Know, Second Edition
From the Francis J. Curry National Tuberculosis Center
Retention of Homeless Clients in HIV Care
Report from Division of Training and Technical Assistance, HIV/AIDS Bureau, Health Resources and Services Administration (HRSA)
Tuberculosis Transmission in a Homeless Shelter Population --- New York, 2000—2003
From Centers for Disease Control and Prevention (CDC)’s MMWR Weekly February 18, 2005 / 54(06);149-152
Street Smart: Reducing HIV Risk Among Runaway and Homeless Youths
Prevention Program fact sheet from the Divisions of HIV/AIDS Prevention of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Prevention and Control of Tuberculosis Among Homeless Persons: Recommendations of the Advisory Council for the Elimination of Tuberculosis
From CDC’s MMWR Reports and Recommendations: April 17, 1992 / Vol. 41 / No. 1
HIV/AIDS and Homelessness
From HRSA Care ACTION
HIV and Homelessness: Recommendations for Clinical Practice and Public Policy
Guide from the Health Care for the Homeless Clinicians’ Network, National Health Care for the Homeless Council, Inc.
Adapting Your Practice: Treatment and Recommendations for Homeless Patients with HIV/AIDS
From Health Care for the Homeless Clinicians’ Network
Condensed version from Health Resources and Services Administration (HRSA)/HIV/AIDS Bureau (HAB) Homelessness and Housing Workgroup
HIV/AIDS Resources
From National Health Care for the Homeless Council
Combating Tuberculosis & Homelessness: Recommendations for Policy & Practice
From National Health Care for the Homeless Council
Tuberculosis Resources
From National Health Care for the Homeless Council
Adapting Your Practice: Treatment and Recommendations for Homeless Patients with Chlamydial or Gonococcal Infections
From Health Care for the Homeless Clinicians’ Network
Homelessness and HIV/AIDS
From the National Alliance to End Homelessness
What are Homeless Persons’ HIV Prevention Needs?
From Center for AIDS Prevention Studies, University of California San Francisco
Adapting Your Practice: General Recommendations For The Care Of Homeless Patients
From Health Care for the Homeless Clinicians' Network
Crossing to Safety: Transgender Health and Homelessness
From Health Care for the Homeless Clinicians’ Network
HIV Risk Profile and Prostitution Among Female Street Youths
Abstract of an article from the Journal of Urban Health, Dec. 2002 / 79(4):525-35
HIV/AIDS and Homelessness
Fact sheet from the National Coalition for the Homeless
1 Get the Facts: Who Is Homeless?: National Resource and Training Center on Homelessness and Mental Illness,
Center for Mental Health Services,
Substance Abuse and Mental Health Services Administration,
U.S. Department of Health and Human Services
2 HIV/AIDS and Homelessness Fact Sheet, National Coalition for the Homeless
3 Zolopa; Paris; Susser; Fournier; Torres
4 Goldfinger, as cited in ACLU
5 HIV and Homelessness: Recommendations for Clinical Practice and Public Policy
