Problem - In Houston in the mid-1990's, there was a fissure among community service providers regarding HIV and substance abuse. Substance abuse treatment providers were not prepared to deal with HIV-related issues affecting their clients, particularly HIV-medication adherence. Most HIV/AIDS service providers were well-versed in HIV treatment, but they were hesitant to deal with the dual issues of substance abuse and HIV. Additionally, housing providers preferred to offer shelter to those with less complicated health and social problems. Thus, few adequate service options existed for HIV+ substance users, especially those without consistent housing.

For HIV+ homeless persons with substance abuse problems, the "revolving doors" of the county hospital or jail were the only options for temporarily getting off the street. Law enforcement officers would bring them to the county hospital or jail for an overnight admission to "dry out". When released, they returned to the streets only to be re-admitted for the same reason a few days later. Neither the hospital nor jail offered any real assistance in breaking out of this cycle.

Project Model - The Houston MDI project addressed the need in Harris County, Texas for housing for homeless HIV + individuals, especially those with complicating health issues such as substance abuse and mental health. The original project model was designed to provide homeless individuals who were HIV+ and chemically dependent 14 days of temporary housing in a medical environment with the following services: 1) immediate referral services and access to transportation through a crisis hotline staffed by Crisis Intervention; 2) medical stabilization and short-term housing through the University of Texas - Houston Recovery Campus (HRC); 3) enrollment in long-term medical care; 4) case management and long-term counseling through the Montrose Counseling Center; 5) access to a newly created HIV/AIDS friendly housing electronic database and printed directory for long-term housing referrals through Houston HIV Regional Resource Group; and 6) financial assistance (deposit) for long-term housing through The Bering Omega Community Service.

Funded by the Human Resources Services Administration (HRSA).