Homeless persons with AIDS and HIV infection face significant health hazards during the daily struggle for survival on the streets and in the crowded shelters of our cities. This article offers a historical perspective on the evolution of the AIDS epidemic within the homeless population of Boston and examines the demographics, risk behaviors, and survival statistics of that epidemic. The Boston Health Care for the Homeless Program is presented as a model of service delivery that offers quality health care to homeless persons with AIDS while addressing the special needs of those bound by the immediacy of the next meal and a night's shelter. Health care is inextricably woven into the fabric of social policy and cannot be delivered without an accessible network of housing, entitlement, job training, mental health, and substance-abuse services.



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