There are several contributing factors that make it challenging for homeless people who are living with HIV/AIDS to be adherent to their medical appointments and treatment regimens, or to even get into care in the first place. These individuals have very little or no income, which presents barriers in terms of paying for healthcare services and medication, as well as simply being able to afford transportation to and from appointments. In addition to financial barriers, the instability of homelessness means that it is very difficult to maintain the consistency required to manage a chronic illness like HIV/AIDS.
Also, many of the individuals who we serve here have not completed a full education. So, even when they are able to access care and make their medical appointments, they may not fully understand how or when to take their medications, how to read or interpret the label, or how to communicate effectively with their healthcare provider. What’s more, many of our clients are dealing with other issues before they even come to us – things like mental illness or a substance abuse problem, which only add to the barriers they must contend with.
Stigma and discrimination play a role as well. These individuals may feel stigmatised, one, because they are homeless, and, two, because of their HIV/AIDS diagnosis. We have individuals who are adamant that they don’t want to disclose their HIV status because of the stigma and/or discrimination they anticipate from their community or their family, meaning that they may be reluctant to access care even when it is available to them.