This article was downloaded by: [New York University] On: 07 May 2015, At: 09:13 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Psychoactive Drugs Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujpd20
Establishing a House for The HIV-Positive Intravenous Drug Abuser Who Is Homeless: Analysis of a Closing a
b
Geoffrey L. Greif , Curtis Price & Ferne Johnson
b
a
School of Social Work, University of Maryland at Baltimore , 525 West Redwood Street, Baltimore , Maryland , 21201 b
Health Education Resource Organization (HERO) , Baltimore , Maryland Published online: 20 Jan 2012.
To cite this article: Geoffrey L. Greif , Curtis Price & Ferne Johnson (1990) Establishing a House for The HIV-Positive Intravenous Drug Abuser Who Is Homeless: Analysis of a Closing, Journal of Psychoactive Drugs, 22:3, 351-353, DOI: 10.1080/02791072.1990.10472559 To link to this article: http://dx.doi.org/10.1080/02791072.1990.10472559
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Short Communication
Downloaded by [New York University] at 09:13 07 May 2015
ESTABLISHING A HOUSE FOR THE HIV-POSITIVE INTRAVENOUS DRUG ABUSER WHO IS HOMELESS: ANALYSIS OF A CLOSING
for the Hlv-positive drug abuser. However, the home was unsuccessful in its first attempt and had to be closed after six months. Despite its closing, drug abuse counselors concerned about housing needs can learn from this experience. The idea for a home emerged from a support group led by staff persons at the Health Education Resource Organization (HERO). HERO, a grass-roots organization created in 1983 to respond to the growing HIV-positive population in Baltimore, now provides outreach, education, and counseling throughout Maryland. As part of their drug abuse outreach program, a group was organized in 1988 to provide counseling, education, and support to IVDAs who had tested positive for Hl V, The membership, which averages between 10 and 15 people, is racially diverse and about two-thirds male. Due to the antiauthoritarian themes often present among this population, the structure of the group is left open, with members feeling free to come and go as they wish (see Greif & Price 1988). The group leader (the second author of the present article) is an indigenous worker who lives in the community he serves. Because of the growing need for housing by this population, some members of the group began to lobby in the fall of 1988 for the establishment of a residence that could serve, on a temporary basis, as a way station to more permanent housing. HERO, as an agency, became involved in working with the group members to establish the residence. The residence was to serve not only members of the group but others in the community who were positive, had a history of drug abuse, and were temporarily homeless. The next few months were absorbed with finding a house, raising money for the initial security deposit (a white elephant and bake sale was held), furnishing the house, and keeping its location confidential. The issue about confidentiality evolved from the fear that the neighbors would object to having a house for Hlv-positive Pe0ple nearby. A three-bedroom house in a transitional neighborhood was finally rented. This location was believed to be key to its invisibility. As one resident said, "People in this area don't get suspicious with people coming and going at all hours of the night. They probably think we have a shooting gallery here." The implication behind this statement was that while neighbors would not object to drug abuse on their block they would object to people who were HIV positive. A bare minimum fee for rent and food was established ($57 per week, which could be paid by either a paycheck or social services and food stamps), with the goal being
Geoffrey L. Greif, D.S.W., A.C.S.W.· Curtis Price·· Ferne Johnson·· One of the greatest needs for the drug abuser who is living on the street and is diagnosed as having human immunodeficiency virus (i.e., HIV positive) is housing. Urban intravenous drug abusers (IVDAs) are often bereft of stabl e housing due to their lifestyle. When they are diagnosed as being Hl V positive, the likel ihood of finding stable housing becomes even more remote. In some cases, it has been reported that shelters for the homeless discourag e adm ission of thi s population once their diagnosis is known . Som etimes IVDAs cut themselves off from possible housing. The preexisting tendency toward alienation, often present among drug abusers , is heightened by the HIV-positive diagnosis. The mixture of a fatalistic attitude and feelings of worthlessness prevent support systems from getting close to them. In other cases, it is their families who reject them. Already wary of the drug abuser, when family members learn of the HIV-positive diagnosis they become fearful of contagion and the stigma associated with having AIDS. As a result, they may sever their already tenuous connection with the addict. This familial rejection can last indefinitely or until a new crisis triggers a reconciliation with some or all family members (Greif & Porembski 1987). In many cases, however, the HI V-positive drug abuser is on the street with few housing options. Throughout most of 1989, Maryland ranked ninth in the nation for AIDS diagnoses made (Centers for Disease Control 1989), with Baltimore being the home of most of those diagnosed individuals. One attempt to cope with a growing housing shortage among this population in Baltimore was the establishment of a temporary residence
mv
"School of Social WoJk, University of Maryland at Baltimore, 525 West Redwood Street, Baltimore, Maryland 21201 . ""Health Education Resource Organization (HERO), Baltimore, Maryland.
J OUTna/ of Psychoactive Drugs
351
\bL 22(3). Jul-Sep 1990
Short Communication
Greif, Price & Johnson
frequent source of strain.
to make the house self-sufficient at the lowest possible cost to the residents. This cost insured that the residents took some financial responsibility for the house. No funds were sought from outside sources as it was believed that selfsufficiency of the house and its residents was of primary importance.
Dealing with the Virus and Confidentiality One of the rules governing confidentiality was that a resident must tell the other residents when a guest came to the house who was not HIV positive. Conversations about mv/AIDS could be curtailed and the residents' confidentiality concerning their diagnosis could be maintained. This was not a problem for the residents during the six months the house was functional, but posed a threat to the very existence of the house if its location had become known.
Downloaded by [New York University] at 09:13 07 May 2015
MAINTAINING THE HOUSE As the planners involved with the establishment of the residence had been completely absorbed with locating a house for months, they did not fully anticipate the problems that might emerge once it became operational. Several problems had to be confronted immediately; these are seen as growing pains that are generic both to begin ning a group home and also to the issues constantly facing the HIV-positive drug abuser.
LeadershiplAuthority The leadership of the house (i.e., the steering committee, the HERO leader, and the house manager) was often placed in untenable positions. For example, one house rule was that drugs could not be used on the premises or by any of the residents. Yet proving if someone was high was practically impossible. The house manager might think that one of the members looked high when he came home, but would be unable to prove it; the leader from HERO would be told to confront the resident, who would invariably deny it. As denial is a commonly used defense among drug abusers, particularly when they are HIV positive (Sorensen, Costantini & London 1989), such confrontations occurred frequently. Another rule was that rent had to paid on time. However, if a payment was missed, the leadership was placed in a bind. Unless another suitable resident was immediately available, the house would be short money and would have to close. If they admitted an unscreened resident into the home, they were opening themselves up to other potential problems related to the new resident's suitability for the living arrangement. As tensions grew, the strain on the house manager led to his relapse and subsequent removal from the home. The only potential manager was a recovering alcoholic who also relapsed soon after he became house manager. At that point the house was closed.
Designating the Population to Be Served Following initial problems with resident selection, a process began in which an ideal profile for a resident emerged: an Hlv-positivc male (as mixing males and females was problematic), employed or employable, temporarily homeless (with the potential for permanent residence elsewhere after three to six months in the house), attending Alcoholics Anonymous or Narcotics Anonymous, and committed to the idea of the group home. When many potential members fell short of this profile, the selection process became difficult. With only six beds in the house, a great demand , and people frequently staying only for short periods of time, finding stable members was the most compelling problem. Structure It was immediately apparent that insufficient rules had been established for behavior. This led to a crisis among the membership and commitment to the house. The original laxity in the rules - a response to the antiauthoritarian theme prevalent in this population - resulted in some individuals falling through the cracks and beginning to use drugs again. It was decided that a clear structure was needed. A steering committee was established that was composed of group members, the group leader from HERO, and residents. A strict set of rules governing behavior, which was adapted from a halfway house, was adopted. These were posted in the front hallway and were constantly referred to when behavior was challenged. The responsibility for the chores was decided on a weekly basis. Residents cooked for whomever was home at the time. Food was bought for the house by the group leader who collected all monies. A resident, designated as house manager, was in charge of daily operations. Despite the posted rules, he was often confronted with having to make administrative decisions about members' behavior. Balancing peer and supervisory functions was a Journal ofPsy choa ctive Drugs
BENEFITS OF THE HOUSE For the residents who stayed in the house while it was functional, with the possible exception of the two who relapsed, the benefits were many, though short-lived. Not only were the residents receiving housing, they were in an atmosphere where they could learn and talk about being HIV positive. As one resident reported while the house was functional, "Aside from the group, there is no other place to go to talk about the virus. Here, it is okay." Another resident said, "All of us have fears about certain things. We need to know how to talk about sex -like how would I tell so-and-so some things about myself, but not everything. Sometimes we'll role-play and we joke about 352
\bl. 22(3), Jul-Sep 1990
Downloaded by [New York University] at 09:13 07 May 2015
Greif, Price & Johnson
it. A lot of other times the virus doesn't come up and its like we're just living here." The house provided the ongoing support and stability that so few of this population have. Benefits typical of group membership (i .e., having an emotional outlet, establishing a sense of kin, and having opportunities for change and growth) could be found (Gambe & Getzel 1989). For a short period, the house was a living testament to the feeling of empowerment that is possible for the HIVpo sitive person, which is believed to be very important in coping with the virus (Haney 1988). The residents took pride in the fact that the house was a self-help effort that was totally self-supporting without any federal or state funding, and filled a gap that existing agencies were not providing. Despite these pluses, failure occurred. It was the unrelenting pressures inherent in drug addiction, perhaps exacerbated by the HlV-positive diagnosis, that fmally tipped the house into becoming dysfunctional. In addition, the group may have attempted to leap too far without having experimented first with other group activities that would have tested the group's ability to later establish a house. In a way, they may have been trying to do too much with too little. Outside financial support could have helped them weather many storms. With the closing, the energy that many of the group members had poured into the house was redirected toward group activities. Picnics and other outings were planned that provided a new basis for interaction. The cohesion among the group members increased. Perhaps, these ac-
tivities would have been a more appropriate interim step as a preparation for the house. Housing continued to be a primary focus of the discussions of the group. With the experience and knowledge that the group had gained, the housing discussions became more informative. The members had learned a great deal about how the system works.
CONCLUSION Group members and the leader from HERO are again considering a new house. As part of this process they are (I) spending more time in the planning stage, paying particular attention to establishing workable rules, and finding outside funding so that they do not have to maintain an unstable resident solely because he is providing rent; (2) considering instituting a screening period before a resident is brought into the house, such as observing the candidate in a group for a month before he enters the house in order to minimize the addition of unstable influences; and (3) attempting to clarify the role of the house manager and the agency leader (e.g., will they have the ability to immediately expel a resident they suspect has relapsed?). Such housing does not provide a living situation free of problems; nor is it a panacea for having an Hlv-positive diagnosis. However, it was one way to begin to reduce the pain that accompanies such a diagnosis. Counselors need to work for alternative housing and other concrete services to fill the gaps left by shelters and government agencies (First, Roth & Arewa 1988) that appear hesitant or unwilling to work with this increasing population.
REFERENCES Centers for Disease Control. 1989 . Morbidity and Mortality Weekly Report Vol. 38(August 25 ): 575 . First. R.I.; Roth. D. & Arewa, B.D. 1988. Homelessness : Understanding the dimensions of the problem for minorities. Social Work Vol. 33(2): 120 -124 . Gambe, R. & Getzel, G. 1989. Group work with gay men with AIDS . Social Casework Vol. 70 : 172-179 . Greif. G.L & Porembski, E. 1987. Significant others of LV. drug abusers with AIDS : Implications for treatment. Journal ofSubsta/lu Abuse
Journal ofPsychoactive Drugs
Treatment Vol. 4: 151-155. Greif. G.L & Price. C . 1988 . A community-based support group for HIV positive LV. drug abusers: The HERO program. Journal of Substance Abuse Treatment Vol. 5: 263-266. Haney. P. 1988. Providing empowerment to the person with AIDS. Social Work Vol. 33(3): 251-253. Sorensen. I.L.; Costantini. M.F. & London. I.A . 1989. Coping with AIDS: Strategies forpatienlS and staff in drug abuse treatment programs. Journal ofPsychoactive Drugs Vol. 21(4): 435 -440.
353
\bl. 22(3), Jul-Sep 1990
Journal of Psychoactive Drugs Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujpd20
Establishing a House for The HIV-Positive Intravenous Drug Abuser Who Is Homeless: Analysis of a Closing a
b
Geoffrey L. Greif , Curtis Price & Ferne Johnson
b
a
School of Social Work, University of Maryland at Baltimore , 525 West Redwood Street, Baltimore , Maryland , 21201 b
Health Education Resource Organization (HERO) , Baltimore , Maryland Published online: 20 Jan 2012.
To cite this article: Geoffrey L. Greif , Curtis Price & Ferne Johnson (1990) Establishing a House for The HIV-Positive Intravenous Drug Abuser Who Is Homeless: Analysis of a Closing, Journal of Psychoactive Drugs, 22:3, 351-353, DOI: 10.1080/02791072.1990.10472559 To link to this article: http://dx.doi.org/10.1080/02791072.1990.10472559
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Short Communication
Downloaded by [New York University] at 09:13 07 May 2015
ESTABLISHING A HOUSE FOR THE HIV-POSITIVE INTRAVENOUS DRUG ABUSER WHO IS HOMELESS: ANALYSIS OF A CLOSING
for the Hlv-positive drug abuser. However, the home was unsuccessful in its first attempt and had to be closed after six months. Despite its closing, drug abuse counselors concerned about housing needs can learn from this experience. The idea for a home emerged from a support group led by staff persons at the Health Education Resource Organization (HERO). HERO, a grass-roots organization created in 1983 to respond to the growing HIV-positive population in Baltimore, now provides outreach, education, and counseling throughout Maryland. As part of their drug abuse outreach program, a group was organized in 1988 to provide counseling, education, and support to IVDAs who had tested positive for Hl V, The membership, which averages between 10 and 15 people, is racially diverse and about two-thirds male. Due to the antiauthoritarian themes often present among this population, the structure of the group is left open, with members feeling free to come and go as they wish (see Greif & Price 1988). The group leader (the second author of the present article) is an indigenous worker who lives in the community he serves. Because of the growing need for housing by this population, some members of the group began to lobby in the fall of 1988 for the establishment of a residence that could serve, on a temporary basis, as a way station to more permanent housing. HERO, as an agency, became involved in working with the group members to establish the residence. The residence was to serve not only members of the group but others in the community who were positive, had a history of drug abuse, and were temporarily homeless. The next few months were absorbed with finding a house, raising money for the initial security deposit (a white elephant and bake sale was held), furnishing the house, and keeping its location confidential. The issue about confidentiality evolved from the fear that the neighbors would object to having a house for Hlv-positive Pe0ple nearby. A three-bedroom house in a transitional neighborhood was finally rented. This location was believed to be key to its invisibility. As one resident said, "People in this area don't get suspicious with people coming and going at all hours of the night. They probably think we have a shooting gallery here." The implication behind this statement was that while neighbors would not object to drug abuse on their block they would object to people who were HIV positive. A bare minimum fee for rent and food was established ($57 per week, which could be paid by either a paycheck or social services and food stamps), with the goal being
Geoffrey L. Greif, D.S.W., A.C.S.W.· Curtis Price·· Ferne Johnson·· One of the greatest needs for the drug abuser who is living on the street and is diagnosed as having human immunodeficiency virus (i.e., HIV positive) is housing. Urban intravenous drug abusers (IVDAs) are often bereft of stabl e housing due to their lifestyle. When they are diagnosed as being Hl V positive, the likel ihood of finding stable housing becomes even more remote. In some cases, it has been reported that shelters for the homeless discourag e adm ission of thi s population once their diagnosis is known . Som etimes IVDAs cut themselves off from possible housing. The preexisting tendency toward alienation, often present among drug abusers , is heightened by the HIV-positive diagnosis. The mixture of a fatalistic attitude and feelings of worthlessness prevent support systems from getting close to them. In other cases, it is their families who reject them. Already wary of the drug abuser, when family members learn of the HIV-positive diagnosis they become fearful of contagion and the stigma associated with having AIDS. As a result, they may sever their already tenuous connection with the addict. This familial rejection can last indefinitely or until a new crisis triggers a reconciliation with some or all family members (Greif & Porembski 1987). In many cases, however, the HI V-positive drug abuser is on the street with few housing options. Throughout most of 1989, Maryland ranked ninth in the nation for AIDS diagnoses made (Centers for Disease Control 1989), with Baltimore being the home of most of those diagnosed individuals. One attempt to cope with a growing housing shortage among this population in Baltimore was the establishment of a temporary residence
mv
"School of Social WoJk, University of Maryland at Baltimore, 525 West Redwood Street, Baltimore, Maryland 21201 . ""Health Education Resource Organization (HERO), Baltimore, Maryland.
J OUTna/ of Psychoactive Drugs
351
\bL 22(3). Jul-Sep 1990
Short Communication
Greif, Price & Johnson
frequent source of strain.
to make the house self-sufficient at the lowest possible cost to the residents. This cost insured that the residents took some financial responsibility for the house. No funds were sought from outside sources as it was believed that selfsufficiency of the house and its residents was of primary importance.
Dealing with the Virus and Confidentiality One of the rules governing confidentiality was that a resident must tell the other residents when a guest came to the house who was not HIV positive. Conversations about mv/AIDS could be curtailed and the residents' confidentiality concerning their diagnosis could be maintained. This was not a problem for the residents during the six months the house was functional, but posed a threat to the very existence of the house if its location had become known.
Downloaded by [New York University] at 09:13 07 May 2015
MAINTAINING THE HOUSE As the planners involved with the establishment of the residence had been completely absorbed with locating a house for months, they did not fully anticipate the problems that might emerge once it became operational. Several problems had to be confronted immediately; these are seen as growing pains that are generic both to begin ning a group home and also to the issues constantly facing the HIV-positive drug abuser.
LeadershiplAuthority The leadership of the house (i.e., the steering committee, the HERO leader, and the house manager) was often placed in untenable positions. For example, one house rule was that drugs could not be used on the premises or by any of the residents. Yet proving if someone was high was practically impossible. The house manager might think that one of the members looked high when he came home, but would be unable to prove it; the leader from HERO would be told to confront the resident, who would invariably deny it. As denial is a commonly used defense among drug abusers, particularly when they are HIV positive (Sorensen, Costantini & London 1989), such confrontations occurred frequently. Another rule was that rent had to paid on time. However, if a payment was missed, the leadership was placed in a bind. Unless another suitable resident was immediately available, the house would be short money and would have to close. If they admitted an unscreened resident into the home, they were opening themselves up to other potential problems related to the new resident's suitability for the living arrangement. As tensions grew, the strain on the house manager led to his relapse and subsequent removal from the home. The only potential manager was a recovering alcoholic who also relapsed soon after he became house manager. At that point the house was closed.
Designating the Population to Be Served Following initial problems with resident selection, a process began in which an ideal profile for a resident emerged: an Hlv-positivc male (as mixing males and females was problematic), employed or employable, temporarily homeless (with the potential for permanent residence elsewhere after three to six months in the house), attending Alcoholics Anonymous or Narcotics Anonymous, and committed to the idea of the group home. When many potential members fell short of this profile, the selection process became difficult. With only six beds in the house, a great demand , and people frequently staying only for short periods of time, finding stable members was the most compelling problem. Structure It was immediately apparent that insufficient rules had been established for behavior. This led to a crisis among the membership and commitment to the house. The original laxity in the rules - a response to the antiauthoritarian theme prevalent in this population - resulted in some individuals falling through the cracks and beginning to use drugs again. It was decided that a clear structure was needed. A steering committee was established that was composed of group members, the group leader from HERO, and residents. A strict set of rules governing behavior, which was adapted from a halfway house, was adopted. These were posted in the front hallway and were constantly referred to when behavior was challenged. The responsibility for the chores was decided on a weekly basis. Residents cooked for whomever was home at the time. Food was bought for the house by the group leader who collected all monies. A resident, designated as house manager, was in charge of daily operations. Despite the posted rules, he was often confronted with having to make administrative decisions about members' behavior. Balancing peer and supervisory functions was a Journal ofPsy choa ctive Drugs
BENEFITS OF THE HOUSE For the residents who stayed in the house while it was functional, with the possible exception of the two who relapsed, the benefits were many, though short-lived. Not only were the residents receiving housing, they were in an atmosphere where they could learn and talk about being HIV positive. As one resident reported while the house was functional, "Aside from the group, there is no other place to go to talk about the virus. Here, it is okay." Another resident said, "All of us have fears about certain things. We need to know how to talk about sex -like how would I tell so-and-so some things about myself, but not everything. Sometimes we'll role-play and we joke about 352
\bl. 22(3), Jul-Sep 1990
Downloaded by [New York University] at 09:13 07 May 2015
Greif, Price & Johnson
it. A lot of other times the virus doesn't come up and its like we're just living here." The house provided the ongoing support and stability that so few of this population have. Benefits typical of group membership (i .e., having an emotional outlet, establishing a sense of kin, and having opportunities for change and growth) could be found (Gambe & Getzel 1989). For a short period, the house was a living testament to the feeling of empowerment that is possible for the HIVpo sitive person, which is believed to be very important in coping with the virus (Haney 1988). The residents took pride in the fact that the house was a self-help effort that was totally self-supporting without any federal or state funding, and filled a gap that existing agencies were not providing. Despite these pluses, failure occurred. It was the unrelenting pressures inherent in drug addiction, perhaps exacerbated by the HlV-positive diagnosis, that fmally tipped the house into becoming dysfunctional. In addition, the group may have attempted to leap too far without having experimented first with other group activities that would have tested the group's ability to later establish a house. In a way, they may have been trying to do too much with too little. Outside financial support could have helped them weather many storms. With the closing, the energy that many of the group members had poured into the house was redirected toward group activities. Picnics and other outings were planned that provided a new basis for interaction. The cohesion among the group members increased. Perhaps, these ac-
tivities would have been a more appropriate interim step as a preparation for the house. Housing continued to be a primary focus of the discussions of the group. With the experience and knowledge that the group had gained, the housing discussions became more informative. The members had learned a great deal about how the system works.
CONCLUSION Group members and the leader from HERO are again considering a new house. As part of this process they are (I) spending more time in the planning stage, paying particular attention to establishing workable rules, and finding outside funding so that they do not have to maintain an unstable resident solely because he is providing rent; (2) considering instituting a screening period before a resident is brought into the house, such as observing the candidate in a group for a month before he enters the house in order to minimize the addition of unstable influences; and (3) attempting to clarify the role of the house manager and the agency leader (e.g., will they have the ability to immediately expel a resident they suspect has relapsed?). Such housing does not provide a living situation free of problems; nor is it a panacea for having an Hlv-positive diagnosis. However, it was one way to begin to reduce the pain that accompanies such a diagnosis. Counselors need to work for alternative housing and other concrete services to fill the gaps left by shelters and government agencies (First, Roth & Arewa 1988) that appear hesitant or unwilling to work with this increasing population.
REFERENCES Centers for Disease Control. 1989 . Morbidity and Mortality Weekly Report Vol. 38(August 25 ): 575 . First. R.I.; Roth. D. & Arewa, B.D. 1988. Homelessness : Understanding the dimensions of the problem for minorities. Social Work Vol. 33(2): 120 -124 . Gambe, R. & Getzel, G. 1989. Group work with gay men with AIDS . Social Casework Vol. 70 : 172-179 . Greif. G.L & Porembski, E. 1987. Significant others of LV. drug abusers with AIDS : Implications for treatment. Journal ofSubsta/lu Abuse
Journal ofPsychoactive Drugs
Treatment Vol. 4: 151-155. Greif. G.L & Price. C . 1988 . A community-based support group for HIV positive LV. drug abusers: The HERO program. Journal of Substance Abuse Treatment Vol. 5: 263-266. Haney. P. 1988. Providing empowerment to the person with AIDS. Social Work Vol. 33(3): 251-253. Sorensen. I.L.; Costantini. M.F. & London. I.A . 1989. Coping with AIDS: Strategies forpatienlS and staff in drug abuse treatment programs. Journal ofPsychoactive Drugs Vol. 21(4): 435 -440.
353
\bl. 22(3), Jul-Sep 1990
