One section of the population that is particularly at risk of contacting AIDS is the impoverished. It has been shown that there is a strong positive correlation between cumulative AIDS cases and extreme poverty in Philadelphia, suggesting that poverty and AIDS may be related. Currently, ActionAIDS helps to provide housing to over 600 families living with HIV each year.[i] Yet, little has been done to prevent this demographic from contracting the disease in the first place. In a study on the relationship between homelessness and HIV/AIDS status, Culhane et. al. found that AIDS status in homeless shelters was “nine times the three year incidence for the general population between 1992 and 1994.”[ii]  A study done in Los Angeles suggests that the shelter is the place to concentrate prevention initiatives. The study specifically focuses on women who live in low-income housing verses those who frequent homeless shelters. The study found that even slightly better housing environment provides higher protection for women, stating that “the rates of substance use and abuse, violence, and HIV risk remained strikingly higher among sheltered women than among housed women.”[iii] This finding is significant because it implicates homeless shelters in HIV/AIDS prevention methods. Although ActionAIDS provides housing opportunities to those who have already contracted HIV, it is necessary to prevent infection beforehand. Specifically, prevention programs should occur in these shelters where “the group setting…may facilitate the more intensive services that women in these settings need.”[iv] Wenzel indicates that there would be little difficulty in implementing preventive measures in tandem with “assessment for experiences of violence and substance use.”[v] In fact, these assessments “can be conducted as part of routine primary care.”[vi] It is important that Philadelphia employs healthcare services that focus on AIDS prevention to homeless shelters. Healthcare workers could engage in conversations with shelter-dwellers and add HIV education to their current healthcare visits.

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Additionally, this same service could distribute condoms and administer HIV testing in homeless shelters and soup kitchens: places where an impoverished person would visit. In a study done by Cederbaum et. al., African American drug users were asked what factors would increase the likelihood of condom use. The most popular responses were, “having condoms,” and “being able to get condoms,”[vii] suggesting that simply making condoms more available would increase their usage. According to the Planned Parenthood website[viii], a single condom costs $.50, meaning that for $20,250 each of Philadelphia’s three major homeless shelters (In Community, Our Brother’s Place, and Project Home) could receive a supply of 13,500 condoms per year.[ix] Similarly, rapid HIV testing services could provide a quick and easy determinate of the HIV status of impoverished people in these locations. According to the AACO website, HIV testing is available in hospitals, clinics, churches, and storefronts across the city, yet homeless shelters are not included on this list.[x] Although rapid testing is more expensive ($15-$17 per test) than and not as accurate as the ELISA test, the results take only 20 minutes to produce, meaning that this test is optimal for homeless people who may not ever come back for the results of an ELISA test.[xi] The AACO estimates that it provides 30,000 tests per year at 40 sites, thus each site would test 750 people per year.[xii] Therefore, adding testing at three major homeless shelters would mean testing an additional 2,250 patients, and spending $33,750 for these three sites. All together, outreach programs to three homeless shelters in the city would cost $54,000.