HIV Care

HIV/AIDS and homelessness are intricately intertwined. Common circumstances around homelessness—living with a substance use disorder and injecting drugs, staying in shelters or on the streets with a lowered ability to form stable sexual relationships—leave individuals at disproportionate risk for contracting HIV. Those living with the virus while unhoused are then at greater risk for developing AIDS and dying prematurely. Continuous treatment can be difficult to access and adhere to in the context of other health and general day-to-day instabilities. And the harsh conditions of homelessness—wherein access to nutrition, warmth, privacy, a social support system, and other basic material and social needs is not a given—leave individuals and their immune systems vulnerable to additional infections and complications.

Our dedicated HIV team is committed to education, care, and advocacy, working one-on-one with those who are already living with HIV/AIDS; collaborating across the organization to focus on prevention, screening, and testing; and providing a model of care for other programs across the country to replicate to better serve patients at the intersection of HIV/AIDS and homelessness.

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Our Impact

300

people experiencing homelessness enrolled in specialized HIV care

of patients have an undetectable HIV viral load – a level of viral suppression that is on par with the national average for all Americans, and means the virus cannot be transmitted

the number of pre-exposure prophylaxis (PrEP) prescriptions provided to patients who use drugs in the year since initiating our low-threshold PrEP Program

Widening Access

We provide HIV screening and testing in the places where patients already are—on the streets and in our clinics, many of which are based at shelters—to identify those living with the virus who were unaware of their status. For those who test positive, staff dedicated specifically to counseling, linkage, and retention ensure that patients are educated about their health, promptly connected to comprehensive treatment, and have not only the knowledge, but also the necessary resources and support to adhere to it. Care is not only tailored to patients’ individual experiences of homelessness, but also is nimble in the face of shared circumstances such as COVID-19. At the height of the pandemic, case managers pivoted to providing telehealth case management to promote HIV care retention. For other patients, HIV prevention resources are also free and offered through low-threshold programming.

Comprehensive Care

BHCHP’s HIV team is composed of physicians, a physician assistant, nurse practitioners, nurses, behavioral health professionals, dentists, and case managers. We provide a multidisciplinary model of care that integrates HIV primary care, behavioral health, oral health, community outreach, and case management services. The holistic treatment the team provides is state-of-the-art and takes into account patients’ other health needs and complexities to prevent negative drug interactions and guarantee that care is high-quality. Expert medical care is supplemented by education and support groups that boost patients’ senses of autonomy, community, and belonging. For patients who are not living with HIV, clinicians provide counseling on how to minimize the risk of contracting the virus and provide the education and resources to do so, from linkage to needle exchange programs, to condoms, to pre-exposure prophylaxis (PrEP).

A Replicable Model

BHCHP’S HIV services program is a national model for care at the intersection of HIV/AIDS and homelessness, providing strong evidence that it is possible to successfully manage HIV disease in homeless individuals through programs tailored to meet their specific needs. Staff extensively study and publish findings from HIV/AIDS programming in order to promote quality improvement for our patient population, support peer organizations, and influence policy to better support unhoused people living with HIV. Published research in journals like the American Journal of Public Health includes:

Delivering Preexposure Prophylaxis to People Who Use Drugs and Experience Homelessness
Enhanced Telehealth Case Management Plus Emergency Financial Assistance for Homeless Experienced People Living With HIV During the COVID-19 Pandemic
The impact of the housing status on clinical outcomes and health care utilization among individuals living with HIV

Make an Appointment

The best way to make an appointment is to call our main number at 857-654-1600. This phone line is answered Monday – Friday, 8:00am – 5:00pm.

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Boston Health Care for the Homeless Program receives HHS funding and has Federal PHS deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.