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NYC Health Center Helps Vulnerable Youth Access HIV Testing, Treatment



When Daniel Marcus* was looking for a safe place where he could be tested for HIV without judgment, he found the Housing Works Outreach to Homeless Youth program on Facebook.

Shortly after he reached out and was connected to care, he was diagnosed with HIV. Housing Works health staff helped him access insurance and medication needed to treat the condition. As a direct result of these connections happening so timely and with tremendous follow-up, Daniel now has 100 percent adherence to his medications.

Daniel is one of the hundreds of youth ages 18 to 24 who call Housing Works their medical home. Many, like Daniel, learn of their services through social media, where peer navigators help connect people like him with health care providers.

The use of social media along with peer navigators is one of the reasons why Housing Works was selected as one of seven winners of the 2014 “Innovations in Care” Award as part of the BD Helping Build Healthy Communities initiative, implemented together with Direct Relief and the National Association of Community Health Centers (NACHC).

The awards seek to recognize innovative approaches to the prevention and treatment of diseases that disproportionately affect vulnerable populations in the U.S.

Housing Works 3 Paint
Photo courtesy of Housing Works

Connecting with the Hard-to-Reach

Housing Works is the nation’s largest community-based AIDS service organization that directs its outreach efforts to homeless and street youth with a focus on young LGBT people of color in vulnerable neighborhoods of Central Brooklyn.

The Housing Works Outreach to Homeless Youth program was established in 2010 to meet the needs of runaway, homeless, and street youth who are, or are at risk of becoming, HIV positive due to sexual abuse, prostitution, sexual exploitation, or similar risk factors.

It’s critical that they connect with some of the hardest-to-reach populations as HIV/AIDS prevalence is three to 16 times higher among people in New York City who are homeless or unstably housed than among people who have stable, adequate housing.

Youth build relationships with street outreach workers and can access comprehensive services, including immediate access to primary and mental health care, substance use treatment, and long-term housing solutions. Additionally, youth learn their HIV status, learn about safe sex practices, and develop a peer network for support.

Photo courtesy of Housing Works
Photo courtesy of Housing Works

Social Media Boosts Scope

Their reach and reputation extend far beyond New York City. Nadine Juste-Beckles, Vice President of Primary Care Operations at Housing Works said that youth have traveled from as far as Georgia, Florida, South Carolina, and North Carolina to receive care. Many of the out-of-state youth find the services on Facebook.

Her colleague Karen Thompson, Vice President of Access to Care and Harm Reduction at Housing Works said that the social media outreach works well because many of the youth are isolated from their families. Additionally, many want to keep their lifestyle secret – particularly their patients who are men who have sex with men (MSM).

The program’s modern way of connecting with their patients has increased awareness of the program, but keeping them involved in their health is where the commitment of Housing Works staff and volunteers come in –  a dedication that earned the attention of BD Helping Build Healthy Communities.

The Undetectables Project has helped more than 80% of the Housing Works HIV+ community achieve — and maintain — viral suppression. Housing Works image.

BD Award Enables Viral Load Suppression Project

The BD Award allowed the clinic to implement a viral load suppression project. Called “The Undetectables Project” the program identifies people who are detectable and provides quarterly incentives in the form of $100 gift cards to review their labs. This helps ensure that they are taking their medications, talking to their provider, and being involved with their treatment plan.

“It’s one thing to get clients to come in for initial intake, it’s another thing to get them actually to come in for primary care,” said Karen.

They’re young adults who feel invincible,” said Nadine, adding that this means they often don’t get up at regular hours or have a routine schedule. “We get them to follow up [with their health care] and get them in a rhythm to maintain a pattern of a healthy, stable life.”

To make their services more accessible, every Thursday at the Eastside location, Housing Works hosts late primary care hours. The clinic remains open until 9 p.m., and they have games and parties to draw in youth.

The agency has a goal of 80 percent viral load suppression. At present, Housing Works has surpassed the goal, averaging 82 percent across all sites.

“We’re very appreciative of [the award],” said Nadine. “It was instrumental in our ability to enhance our services and be able to do things that really make a difference.”

Direct Relief is honored to work with partners like Housing Works who are helping vulnerable youth like Daniel access long-term care in a place where they feel safe and connected.

*name has been changed to protect patient privacy

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