Homelessness itself is hard to envision if you have a home and have never been without one. One can only imagine as one drifts off into a comfortable sleep. Snuggled cozily under my warm comforter that makes me feel safe. Being able to leisurely stroll to my bathroom each morning and reach into my medicine cabinet and pop the four HIV medications that keep me healthy and, most importantly, alive. Is this something I take for granted?
Not at all. Well, not anymore, anyway. I am a longtime AIDS activist who works mostly on access to AIDS treatment, both local and global. Everyone should have access to life-saving AIDS medication and treatment. If you are fortunate enough to have a place to live.
Living with AIDS on the streets is dangerous and has meant certain death for at least 10 people living with AIDS in Philadelphia in the last two years. Living with untreated HIV translates into debilitating painful infections that most people without compromised immune systems have never heard of. These opportunistic infections can take a devastating toll on your body, mind and spirit. It is exacerbated if you are homeless.
AIDS is still a disease that is met with fear and hostility and is highly stigmatized, unlike other illnesses that elicit sympathy and compassion. AIDS is still transmittable unless you are on medication and adhere to medication schedules. HIV treatment is now HIV prevention and is lauded by the National Institutes of Health. It is finally not too much to hope for the end of the epidemic — provided you have a home in which to store and take medications.
An unsanitary shelter system is a breeding ground for contagion. Shelter staffers often confiscate HIV medications. That leaves individuals open to ridicule and makes the streets a better alternative. Studies have proven that housing people with HIV/AIDS is more cost effective than shelters. Cold, tired, sick and hungry people who are homeless are often taken advantage of by predators. Both men and women are offered food, warmth and a place to sleep in exchange for sex. At that point, they have little power in safe-sex negotiations, if any. Philadelphia has an HIV-infection rate five times higher than the national average.
The majority of the funding to house homeless people living with HIV/AIDS comes from the federal government through Housing Opportunities for People With AIDS and, while it’s a good program, it is woefully inadequate. Unlike other major cities with burgeoning HIV infections, Philadelphia contributes nearly nothing to house people with AIDS. At present, Philadelphia has a two-year waiting list for housing. People die waiting. In contrast, New York City houses people with HIV/AIDS in 48-72 hours.
Honestly, no one knows how many homeless people are living with HIV until they are found dead on the street. The last needs assessment for homeless people with AIDS in Philadelphia was conducted in 1996. Due to activist pressure, another is due to begin. Please remember, this World AIDS Day, those who died and will continue to die without human dignity on the streets — until Philadelphia funds programs to house homeless people with AIDS.
