Special Projects of National Significance - Demonstration/Implementation Sites - The proposed Street Medicine Demonstration Site Project aims to address the healthcare disparities faced by individuals experiencing homelessness who are living with or at risk of HIV in the Skid Row area of Los Angeles. This population faces significant barriers to accessing traditional healthcare services, including stigma, lack of transportation, mental health challenges, and substance use disorders. The project will provide a comprehensive, mobile healthcare intervention that delivers essential medical, behavioral, and social services directly to individuals in their lived environments. Through this project, we aim to reduce health disparities, improve linkage and retention in HIV care, and enhance health outcomes for individuals experiencing homelessness by providing needed medical care and partnering with the capacity building and evaluation partners to be selected by HRSA to tailor our approach to outreach, delivery of care, and evaluation of patient outcomes. The Street Medicine Team (SMT) will offer a range of services, including HIV testing, linkage to care, antiretroviral therapy (ART) initiation and adherence support, harm reduction services, mental health and substance use counseling, housing navigation assistance and other enabling services. The program will integrate trauma-informed and harm-reduction approaches to ensure that services are patient-centered and responsive to the unique needs of this vulnerable population. A core component of the intervention will be HIV navigation, utilizing individuals with lived experience to build trust and facilitate engagement in care. Additionally, the program will coordinate closely with evaluation and capacity building partners, local healthcare providers, community-based organizations, and public health agencies to ensure seamless service delivery and continuity of care. The target population includes individuals experiencing unsheltered homelessness in Skid Row who are living with or at risk for HIV, with a particular focus on priority populations identified in the National HIV/AIDS Strategy (NHAS) (2022-2025), including Black, Latino, and American Indian/Alaska Native men who have sex with men (MSM), Black women, transgender women, youth aged 13-24 years, and people who inject drugs (PWID). The program aims to reach and enroll at least 40 individuals in the first year, with the expectation of increasing engagement over time to reach 60 individuals annually for years 2-4.
