The Health of the Homeless - Aids

The CDC reported that in 2003, between 850,000 and 950,000 Americans were living with HIV, the virus that causes AIDS, and 405,926 of those had full-blown AIDS (HIV/AIDS Surveillance Report 2003, vol. 15, March 2005). AIDS diagnoses increased in 2002 for the first time in ten years and increased another 1% between 2002 and 2003. In November 2002 the Food and Drug Administration approved a rapid test for HIV infection that can provide results in twenty minutes. U.S. Health and Human Services Secretary Tommy G. Thompson explained the significance of the test: "Each year, 8,000 HIV-infected people who come to public clinics for HIV testing do not return a week later to receive their test results.… With this new test, in lessthan a half an hour they can learn preliminary information about their HIV status, allowing them to get the care they need to slow the progression of their disease and to take precautionary measures to help prevent the spread of this deadly virus."

The CDC estimates that up to one-fourth of people infected with HIV are not aware of their condition. The CDC is working with health officials to make the rapid test widely available, particularly in places where likely victims reside, such as homeless shelters, drug treatment centers, and jails.

A study of AIDS patients in San Francisco found that poor people die sooner from AIDS ("Study: Disparity between Rich and Poor Mortality: Poor, Disadvantaged People Develop AIDS Faster," AIDS Alert, August 2003). Within five years of diagnosis, fewer than 70% of people living in the city's poorest neighborhoods were still alive, compared with more than 85% of people who lived in the richest neighborhoods. Poor people with HIV usually have a number of co-occurring disorders, such as drug dependence, mental illness, and unstable housing arrangements. The lack of affordable and appropriate housing can be an acute crisis for these individuals, who need a safe shelter that provides protection and comfort, as well as a base from which to receive services, care, and support.

The University of California at San Francisco, in HIV Prevention: Looking Back, Looking Ahead (1995), stated that almost half the homeless are estimated to have two or more of the risk factors associated with HIV—unprotected sex with multiple partners, injection drug use, sex with an injection drug user (IDU), or the exchange of unprotected sex for money or drugs. One-fourth report three or more risk factors. Having multiple sex partners is a risk for HIV, but it is extremely difficult for homeless people to form safe or stable intimate relationships due to drug use, mental illness, violence, or transient living conditions. Many homeless women are victims of rape or battery, and many women and children engage in "survival sex" or the exchange of sex for money, drugs, food, or housing.