Ongoing crisis in Atlanta program keeps those with AIDS/HIV homeless

The thief that punched through the window of Caleb Hobbs’ truck could have stolen his shoes, or the tightly-packed box with his folded socks and underwear.

Instead, the burglar took what Hobbs needed most: a bag that held about $3,000 worth of medicine he takes to control an HIV infection and the effects of a successful battle with an aggressive cancer.

“It could have been worse,” said Hobbs, 29, trying to stay upbeat. “They could have flattened my tires.”

Hobbs became homeless after cancer and a layoff drained his savings, which is why his belongings sit in neat stacks of bags and Sterilite containers behind the hatch of his Volkswagen Tiguan.

Although the city of Atlanta runs a program to house people living with HIV that has tens of millions in unspent funds, none of the four nonprofits that Hobbs tried in recent weeks could take him in. Now he stays with friends, or sometimes in his truck

An ongoing crisis in the $23 million Atlanta's Housing Opportunities for Persons with AIDS program is keeping people with the virus from entering the federally funded program to find shelter. They stay with friends or acquaintances, in their cars, or on the streets, placing their health at risk, doctors, social service workers, advocates and people living with HIV said.

A complicated feud between the city and nonprofit Living Room, a key provider in the program, left more than two dozen counties in the region without a central intake for residents when Living Room lost its contract in July. This has kept housing out of reach for many people with HIV, even when they have an urgent medical need, those interviewed by The Atlanta Journal-Constitution said.

There is no count for how many people have been unable to find shelter because of the closure, although a hotline to help former Living Room clients receives about 20 calls per week looking to enter HOPWA. The impact for metro Atlanta, which has one of the country’s highest rates of new diagnoses for AIDS and HIV, is serious.

Living Room typically took on those who were the hardest to house. When it closed, patients who were not sick enough to admit to the hospital had to return to the streets or be placed in temporary shelters with living conditions that are too harsh for a person with a chronic illness, said Chanel Scott-Dixon, who coordinates social services for Grady Health System’s Ponce de Leon Center. At 6,200 patients, it is one of the largest centers in the nation dedicated to providing medical and support services for those with AIDS and HIV.

“It’s heartbreaking, and we feel helpless because we don’t have anywhere to send our clients,” Scott-Dixon said.

Mayor Keisha Lance Bottoms has has since proposed major administrative changes to HOPWA, but has yet to formally announce when services will resume.

“We are already seeing the benefits of leadership and operational changes instituted by this administration and look forward to announcing even more developments in the very near future,” city spokesman Michael Smith said in a written statement.

HOPE Atlanta will begin assessing clients in person Wednesday as part of a soft roll-out, said Executive Director Jeff Smythe. But it will take time to figure out how to house the people who fell through the cracks.

“What’s so difficult is that there are so many gaps that we haven’t quite gotten our arms around,” said Smythe.

Homelessness dangers

When Living Room closed, the handful of agencies that continue to receive HOPWA dollars directly from the city could still house their own clients. But the Ponce center and others that relied on the Living Room must make do. Its social workers can spend two hours working the phones to find emergency shelter for a single client, which takes time away from dozens of others who also need their help.

Some 60 percent of the center’s clients report at intake that they do not have a stable housing arrangements, said executive director Lisa Roland. The true total is likely higher.

“Other service providers do not have the capacity to serve all of our patients,” Roland said.

One of the center’s social workers recently placed an ailing patient in a church’s short-term shelter, but the fix is only temporary.

“He will die,” said Dr. Jonathan Colasanti, Associate Medical Director of the Ponce center’s Infectious Diseases Program. “I guarantee you a year from now he will be dead if we can’t somehow get him housed in a stable environment.”

The importance of stable housing to those with HIV is hard to understate. A study published in the September issue of the journal AIDS found that being homeless upon diagnosis can be even more deadly than taking intravenous drugs.

Housing also has the power to curb an epidemic. Research shows that having a stable place to live can greatly improve the chances that a person with HIV keeps the virus at undetectable levels in their bloodstream. When it is undetectable, it cannot be transmitted.

Hobbs maintained undetectable levels through months of chemotherapy to battle a rare form of non-Hodgkin lymphoma. He must continue to keep close watch over his health.

On a trip to the Ponce center Wednesday to replace his stolen medication, Hobbs pointed out the shards of glass that remain in his back seat. He had been hospitalized a month and a half ago for pneumonia and did not vacuum to avoid being outside during the recent rains.

“I can’t afford to get sick,” said Hobbs.

Being homeless is hard enough, he said. Hobbs left one roommate who scammed him out of money. He left another because he was being pressured into a sexual relationship.

“I’m all I have,” Hobbs said. “If I break down, who’s going to hold me? Who’s going to pull me back up?”

Filling gaps

The current troubles are among only the latest in a long-running crisis for Atlanta's HOPWA program, which was called out by the U.S. Department of Housing and Urban Development for poor management, substandard housing and failing to spend some $41 million in recent years, among other problems. HUD's administrative enforcement center is investigating.

Nonprofits that serve people living with HIV are using their own money to fill in the gaps, their leaders said. Thrive SS is using its emergency assistance fund to cover client needs, but the $100 stipends it provides can only cover a brief hotel stay, if that, said Larry Scott-Walker, Thrive SS’s executive director.

“It is straining our resources, but it’s what we have to do,” said Scott-Walker.

The Atlanta Harm Reduction Coalition places clients in its own housing network, where the nonprofit pays to shelter clients for a few days to six months. Executive Director Dr. Mojgan Zare worries what will happen if the crisis drags on. There is already a shortage of housing for the homeless.

“It’s just very scary,” Zare said. “How long is this gap going to be? How long will we have do to without these services?”

Hobbs is not waiting for help. He found a new place to stay in Stone Mountain and has more job applications to fill out. A recent interview seemed to go well.

“The only way to push through is to keep a positive attitude,” Hobbs said.

On Wednesday morning, the Ponce center pharmacy replaced his stolen medicine, free of charge.