Manuel Vasquez, and his colleague Marco Partida, are hitting the streets looking for people living with HIV who aren’t in treatment. Backed by grants from the U.S. Centers for Disease Control and Prevention and the California State Office of AIDS, Vasquez and Partida are part of a new San Francisco AIDS Foundation program called “Health Navigation,” which aims to link those who don’t have housing or healthcare to the social services that can help them get into treatment. But, before the two can link clients to health care and other support services, they’ve got to find them. To do that, Vasquez and Partida go into the community armed with compassion, tenacity, and creative strategies to engage some of our city’s highest-needs people.
“A lot of our work has been outreach,” said Vasquez. “We’ve gone down to 6th street and Folsom and talk to people on the street about their health care. We walk through the homeless encampments under the 101 freeway. We start slowly—asking people, how are things going? How’s your medical care?”
The health navigation program is set up to serve people who are HIV-positive—to get people re-engaged in care, on medications and virally suppressed. But HIV stigma often prevents people from coming forward and self-identifying as positive and needing help. Vasquez and Partida know that asking people they meet outright if they’re HIV-positive won’t be effective, so instead, they ask indirect questions like, “Where can we find people who are positive?” and they hand out small cards with their names and contact information, requesting that people who take the cards hand them out, keep one, or get them to the right people.
So far, Health Navigation has seen about 12 clients since it began in August 2015. Some have been referred by Magnet, the sexual health clinic of San Francisco AIDS Foundation, but most are people Vasquez and Partida contacted during their outreach. Vasquez says that most, maybe 80% to 90%, are homeless or marginally housed. The majority of them are men, but Vasquez says that they also offer assistance to women. Many clients use substances, have mental health conditions and other health concerns besides HIV.
“Engaging people on the street can be difficult. Rarely are individuals by themselves and sometimes people are actively using substances while we’re talking to them. We respect that this may be their home. We’re in their space. And we still try to engage them about their healthcare. There are many obstacles individuals face when accessing healthcare. We try to meet people where they are at,” said Vasquez.
While the end goal is to help clients get virally suppressed, to improve their own health and so they can no longer pass on the virus, the health navigators help clients address any and all issues that may ultimately affect that person’s health and wellness. That includes help finding housing, assistance with transportation, enrolling in the AIDS Drug Assistance Program, signing up for MediCal, getting help with substance use issues, learning how to advocate for better healthcare and learning more about how to live well with HIV.
Vasquez has a master’s degree in counseling and psychology, so he’s able to dig deeper into client’s lives and help them figure out how to identify—and overcome—challenges to better health. He’s also well-equipped to handle the assessment and goal-oriented focus of the program. He finds that often, his clients are eager to hear from his own experience with HIV.
“Some of the people I’ve spoken to are positive but don’t know what that means. And HIV has really changed a lot in the past 10—even 5—years. You can take one pill a day and be undetectable. If it’s helpful for the client, I will disclose my HIV status. And people will engage with me about my experience. It can motivate and empower them. It’s gratifying if at the end of the day, people are better informed. And are empowered to be an advocate. And take better care of themselves. My ultimate goal is to help people get to a place where they don’t need my help anymore.”
Are you inspired by the work Manuel and Marco are doing to get people in the community with HIV into care? Share your thanks in the comments below.
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