The Homeless Intravenous Drug Abuser and the AIDS Epidemic

The topics addressed in this chapter deal with interrelationships among three of the most pressing contemporary social and public health issues confronting American society: homelessness, intravenous (IV) drug abuse, and the acquired immunodeficiency syndrome (AIDS) epidemic. Homelessness and IV drug abuse affect each other, and each must be addressed if the AIDS epidemic is to be curtailed and contained. The uncertainties inherent in a state of homelessness prevent most homeless IV drug users (IVDUs) from adopting adequate and sustained risk reduction behavior to avoid transmitting or contracting AIDS. Furthermore, the state of homelessness makes delivery of effective medical and social services a tenuous undertaking at best. This paper will summarize the extent of the problem, describe a number of surveys and exploratory studies of the population, and present examples of programs that affect homeless IVDUs and the AIDS epidemic.