Reflecting on World AIDS Day

Posted by Nancy Southwell, Director of AIDS Services

This year’s World AIDS Day (12/1/09) was themed HIV:Reality to make the point that understanding the facts about HIV/AIDS is key to fighting the prejudice. And that fact reminds us that the fight against prejudice may be a harder struggle than the search for an HIV/AIDS vaccine. I’m particularly sensitive to that fact as I know that the SUS consumers I work with, People Living With AIDS (PLWA), are especially vulnerable to prejudice because their lives are further complicated by homelessness and mental illness, also sometimes by substance abuse, and always by poverty.

There is an abundance of research that conclude that people who are without homes do not manage their health well, do not see doctors regularly, do not take medication as prescribed, and generally have poor nutrition all of which contribute to more acute symptoms, increased hospitalizations, longer hospitalization stays, greater dependency on emergency services and shorter lives. Another fact: these are the people served by SUS. Another fact: these people are American citizens.
Because New York City is at the epicenter of the U.S. epidemic, and because SUS is aligned with the city’s most vulnerable citizens, SUS was awarded a $2.0 million, multi-year grant from the New York City Department of Health and Mental Hygiene via Public Health Solutions . Factors associated with poor adherence to medical care plan and antiretroviral medications will be addressed through this grant. These factors include: mental illness; substance abuse; inadequate housing; lack of transportation; legal difficulties; inadequate access to food; being of racial/ethnic minority; social stigma; lack of knowledge about HIV/AIDS; health care provider bias and miscommunication; health care provider lack of knowledge or adherence to HIV/AIDS clinical guidelines. By reducing viral load in individuals and periodic assessment of HIV transmission risk with harm reduction counseling and partner notification where needed, HIV transmission may ultimately be reduced in the community.

A second grant for $1.75 million from the http://www.samhsa.gov/" target="_blank">Substance Abuse and Mental Health Services Administration (SAMHSA) will allow SUS to do even more. With the federal support we can introduce Wellness Works (an SUS initiative that integrates two evidence based practices – Wellness Self-Management and Integrated Dual Disorder Treatment) at SUS’ PLWA transitional supportive housing programs. “Homelessness is often rooted in underlying mental health conditions and other factors that may require a multifaceted approach,” said SAMHSA Acting Administrator Eric Broderick, DDS, M.P.H. Wellness Works will expand, strengthen, and fully integrate treatment for persons who are homeless and have multiple co-morbidities, including HIV/AIDS.

These awards to SUS will result in enhanced services to homeless New Yorkers with HIV/AIDS, one part of a large fight against one of the world’s biggest challenges. We all need to learn the facts from each other to make our united fight vital and urgent. So I conclude by asking you to comment to this blogpost with methodologies and stories that promote understanding the reality of AIDS.