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Project Med HEART

From September 2013 to February 2017, 9 study sites across the United States participated in a demonstration project to evaluate models of care that linked HIV-positive homeless individuals with needed services and resources. Each study site created a patient-centered medical home (PCMH) to coordinate housing, social, and health services for each participant. The interventions implemented at each site varied, however, each PCMH included the introduction of a network or peer navigator using intensive case management for social services, housing assistance, and HIV care services.) Data were collected prospectively through interviews and HIV medical chart reviews at baseline, 6 months, and 12 months.

The project aimed to answer:

1. What strategies successfully address housing needs of homeless people living with HIV?

2. What does it take to keep homeless people in HIV care?

3. How can we successfully integrate HIV care, mental health services and substance use treatment for homeless people?

4. What does it take to create a medical home for homeless people living with HIV?

The project was supported by the Health Resource and Service Administration (HRSA) Division of HIV/AIDS Bureau Special Projects of National Significance (SPNS). The Center for Advancing Health Policy and Practice at Boston University School of Public Health and Boston Health Care for the Homeless Program served as the evaluation and technical assistance center for the initiative.

Our Yale team led one of the nine demonstration sites, titled Medical Home Engagement and Aligning Lifestyles and Transition from Homelessness (mHEALTH), in partnership with Connecticut Department of Correction, Liberty Community Services, the New Haven Ryan White Continuum of Care, and the Greater New Haven Coalition to End Homelessness.

Funding Provided by:  
Health Resources and Services Administration 

Project Period:  

External Links:

  • Professor of Medicine (Infectious Diseases) and of Epidemiology (Microbial Diseases); Affiliated Faculty, Yale Institute for Global Health; Director, Yale Center for Clinical and Community Research, Department of Medicine; Director, HIV in Prisons Program; Director, Community Health Care Van; Academic Icon Professor of Medicine, University of Malaya-Centre of Excellence for Research in AIDS (CERiA)

    Frederick (Rick) L. Altice is a professor of Medicine, Epidemiology and Public Health and is a clinician, clinical epidemiologist, intervention and implementation science researcher at Yale University School of Medicine and School of Public Health. Dr. Altice’s primary research focuses on interventions and implementation science at the interface between infectious diseases and addiction and he has conducted research in several global health settings. He also has a number of projects working in the criminal justice system, including transitional programs addressing infectious diseases, medications for opioid use disorder (methadone, buprenorphine, extended release naltrexone), mental illness, homelessness and social instability. Specific topics include alcohol, opioid, stimulant and nicotine use disorders on HIV treatment outcomes, HIV and addiction treatment, interface with the criminal justice system, and pharmacokinetic drug interactions between treatment for substance use disorders and antiretroviral and tuberculosis therapy. At a basic level, his research focuses on clinical epidemiology, especially in key populations at risk for HIV (e.g., MSM, TGW, PWID, prisoners, sex workers) and development, adaptation and evaluation of of biomedical and behavioral interventions to improve treatment outcomes. His research, however, has evolved and included development and testing of mobile technologies (mHealth) to intervene with key populations to promote health outcomes.  His research is especially concentrated in health services research techniques with a focus on implementation science, seeking to introduce and scale-up evidence-based interventions in numerous contexts. A number of implementation science strategies are underway to examine scale-up of medication-assisted therapies to treat opioid use disorder in community, criminal justice and in primary care settings. Most recently, his work has been augmented through use of decision science techniques to understand and promote patient preferences, including the development of informed and shared decision-making aids. His work has emerged primarily with a global health focus with funded research projects internationally in Malaysia, Ukraine, Moldova, Armenia, Kyrgyzstan, Peru, and Indonesia. He has participated in projects through the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Agency, Special Projects of National Significance with HRSA, and the Center for Substance Abuse Treatment. He is currently also collaborating on projects with the WHO, UNAIDS, USAID, PEPFAR and UNODC. Current internationally funded projects in dedicated research sites that are being conducted in Malaysia, Ukraine, Moldova, Azerbaijan, Armenia, Kyrgyzstan and Peru. His research and training sites in Malaysia (2005), Peru (2010) and Ukraine (2005) are dedicated training and research sites for the Global Health Equity Scholars Fogarty Training Program and the Doris Duke International Fellowship program. He is currently the director for two International Implementation Science Research and Training Centers with collaborations between Yale University and the University of Malaya and Sichuan University.