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Check back on September 27th for the next chapter in Tom's story!
Chapter One: Spring 2009 -
Tom* left the Dallas County Health Department with his referral and a bus pass to Prism Health North Texas clutched in his hand. He has just found out he is HIV positive and has Hepatitis C. He has nowhere to turn, and no family. At 53 years old, he is struggling to comprehend how and when his life took this turn. His memory is blurred by years of self-medicating with alcohol and drugs. He is a Vietnam veteran, and served his country with honor and pride, but now he has been homeless for years, roaming the city by day and sleeping in different parks at night. All he knows now is that he is ill and needs help.
Tom boards the bus and sets off for Prism Health North Texas’ Peabody Clinic. Tom arrives with no identification and all of his belongings stuffed into an old back pack. He shuffles in the front door, defeated, angry, and mad. After a medical exam and consultation with a physician, Tom is prescribed a 90-day supply of three different medications to begin treating HIV. Tom wonders how he can manage keeping up with this – he has been robbed all too frequently living on the streets and worries he may be robbed again, and lose his medication. He takes only one month supply of the medication and leaves the rest at the clinic, promising to keep his appointments and pick up his medication as necessary.
Chapter Two: Summer 2009 -
Tom has kept his promise – he has not missed a medical or case management appointment since his first visit. His case manager has made sure he receives bus passes that enable him to get to and from his appointments at the clinic. Despite his homelessness, he is determined to stay on his medication regimen, regain his health, and stay healthy. He now has ID and other personal documentation, thanks to assistance from his case manager, which is stored securely at the clinic eliminating the risk of losing them or having them stolen. Tom is now seeing a Behavioral Health Counselor to help address his substance misuse and mental health issues. Slowly but surely, he is learning to trust her.
Unfortunately, he continues to choose living on the streets refusing shelter or housing assistance. As long as he continues to abuse alcohol and drugs, he cannot be housed in a shelter.
Chapter Three: Winter 2012 -
Tom is on his way to his weekly medical visit. It was cold last night sleeping in the park and the warmth of the bus gives him some temporary shelter from the cold that has dipped into the 20’s and 30’s recently. His appointment goes well, he is continuing to stay on his medication and faithfully keep his appointments.
Knowing he will be returning to the streets after his doctor’s appointment, he picks up a new sleeping bag, socks, underwear, and a hygiene kit from his case manager as well as a winter coat from the Community Clothing Closet. His case manager provides him with a snack pack of healthy food to take with him on the bus and gives him a McDonald’s gift card which will give him access to food, hydration, restrooms, and temporary respite from the cold. This may be the only meal he gets today.
Chapter Four: Spring 2014 -
Tom has been living with his HIV diagnosis for five years now. Today, he is headed to the Oak Cliff Health Center where he is now receiving his medical care. He has taken a new step in managing his care - in addition to his weekly medical appointment, today he begins an AIDS Clinical Trials Group research project that researches the health of older people living with HIV. The Oak Cliff Health Center is one of the few community health centers not affiliated with a large academic or governmental medical center. This allows Tom to combine his doctor’s appointments with the trial appointments in the same day.
Tom is an excellent candidate for this trial. He keeps all of his medical appointments, is consistent with his medication and never loses touch with his case manager thanks to the limited use cell phone she has provided him. This has become his lifeline and connection to the care and support he needs.
Chapter Five: Spring 2015 -
Tom is still homeless. Though he is managing his care and keeping his appointments, eventually living on the streets for so long has taken its toll. Tom has become very ill and was rushed to the hospital. He spent days in the hospital recovering. During his stay, his counselor visited him often. She worked with him during his stay and convinced him that continuing to misuse drugs and alcohol, living on the streets and sleeping in parks was not going to help him feel better or become healthier – he needed emergency temporary housing for respite care.
Tom knew he could not leave the hospital and go back to the streets. He simply didn’t have the energy, and knew if he went back it might be his last time.
Chapter Six: Spring/Summer 2015 -
Tom entered respite care in April. It will take the next two months for him to recover. Having a roof over his head feels confining and suffocating, yet he enjoys the softness of a bed, a hot shower every day and the visits from his counselor. He has good days and bad days. One moment he is happy to be in temporary housing, the next he is sad, then angry – a part of him still wants to be on the streets. With each passing day, Tom begins to feel better and is gaining strength, but where will he go when he is fully recovered?
Tom’s counselor wants him to leave the streets. This makes him anxious, but he knows his counselor cares for him and wants the best for him. He puts his trust her as they begin discussing what the transition from respite care will be.
Chapter Seven: Fall 2015 -
After two months in respite, Tom’s health has improved and he is able to leave. He is anxious, nervous and unsure of what lies ahead. With his counselor at his side, Tom enters the apartment. His apartment. He is overwhelmed for a moment, can’t believe what is happening, and is overcome with emotion. Anger and despair have turned into joy and hope.
After years and years of living on the streets, he is home. There is food in the pantry, a bed, and clothes hanging in the closet. And his support system at Prism Health North Texas is right there with him, dedicated to helping him on his journey. For the first time in a very long time, he feels at peace.
Chapter Eight: Today -
Tom is still living in his apartment. He works part-time providing maintenance and cleaning for the property he lives on as well as working for a recycling company. Today, Tom no longer resembles the frail man who walked into Prism Health North Texas for the first time 10 years ago. He is smiling, he is happy. He is almost unrecognizable in khakis and a plaid shirt. He is healthy, engaged in managing his health care and enjoys the routine stability offers. Tom is no longer angry, he has a purpose. He is in charge of his health and life, and he is virally suppressed. The HIV virus is undetectable in his system, therefore untransmittable. He is no longer limited by his illness, but limitless in what he can do now.
*Name changed to protect client confidentiality
Thank you for walking and supporting health care for all North Texans living with HIV. Every dollar you raise impacts a life affected by HIV. Together, one step at a time, we will illuminate a path to better health care and end HIV.