Theme: Models of Care Year: 2024
Background: Knox County, part of Appalachia, in East Tennessee is considered a highly vulnerable area for the opioid epidemic, witnessing high rates of non-fatal/fatal overdoses, along with high rates of hepatitis C (HCV) and HIV transmission. Commencing in 2017, Next Step Initiative Tennessee (NSI) was the area’s first street-based outreach service engaging marginalized people who use drugs in the community.
Description of Program: NSI has focused on overcoming barriers and meeting client needs, based on client input through advisory committees made up of those who use drugs and are experiencing homelessness. NSI has developed programs to help individuals with their laundry, taking showers, and other hygiene necessities. NSI developed a no-cost transitional living program (Noon’s House) for women who would otherwise have no viable housing option. As a continuation of health, NSI is also trained and pursuing mobile HCV and HIV testing in and around high-risk areas in the community.
Effectiveness: To date, NSI has served over 1,000 clients. In the first 6 months of 2023, NSI provided 2,137 meals; 2,113 food bags; 2,286+ doses of naloxone; 142 clients transported to syringe exchange services; 84 safe using kits; 139 showers; 95 laundry services; 41 sets of clothing; and 30+ treatment and sober living referrals.
The Noon’s House program has housed 17 individuals, with each graduate moving to safe, permanent housing with savings averaging over $2,500.
Conclusion and next steps:
Through HepConnect, a Gilead-initiative targeted at reducing the transmission of HCV in Appalachia, NSI has positioned itself to take HCV and HIV testing to the streets using HCV CBO Rapid Testing and INSTI HIV-1/2 Antibody Test Kits.
Disclosure of Interest Statement:
HepConnect, Gilead, United Way, National Health Care for the Homeless Council, Appalachian Community Fund