HIV, Homelessness, And Politics Meet In West Virginia

“Not everybody who quote-unquote ‘looks homeless’ is experiencing homelessness,” Strickland said. “There is a belief that everybody with a bike and a backpack is homeless.”

“A lot of the people that you see are experiencing homelessness are harder to serve,” she added. They have more severe mental health issues, stronger substance use disorders, and more intense physical health issues. They are more likely to wander the streets, or nod off on church steps, or yell, she said. “They need more support, and that makes them more visible.”

Those perceptions drive some of the complaints. Charleston has two shelters for men that have about 135 beds and on any given night they have 60 empty beds. (Some people at Manna Meal complained they are dangerous and have bedbugs.) Another shelter for women, single mothers, and intact families has 76 beds and is usually full every night.

“There are a lot of women we see experiencing unsheltered homelessness,” Strickland said. “The reason they are not in shelters is because of mental health issues, I would say, pretty consistently.”

A Pandemic and an HIV Outbreak

The coronavirus pandemic arrived in Charleston just as signs of the HIV epidemic were being picked up by SOAR and in local emergency rooms. The ensuing scramble to fight a deadly pandemic hobbled testing people who use injection drugs for other diseases, said Christine Teague, director of the Charleston Area Medical Center’s Ryan White HIV Program.

The new numbers were down this winter, but so was testing, as fewer people came to emergency rooms or test sites. “People hunkered down during COVID,” Teague said.

This month, the county’s HIV task force met to discuss restarting many of its testing efforts, and discuss its population with HIV. Most of them are adults 40 or younger, and just over half are unhoused. Almost all of them, 93%, also have hepatitis. With repairs, the county hopes to send a mobile testing van out twice a week and has hired a new disease investigator.

With SOAR prohibited from running a needle exchange, a more restrictive one has opened on the west side of the city, where the nonprofit once worked from a church parking lot. Treating hepatitis C costs the county $25,000 a person, while a new needle costs 50 cents. SOAR still distributes the overdose-reversing drug, naloxone, and has tripled the number of the city’s needle disposal sites in the last six months (by adding two boxes), helping dispose of 50,000 needles in that time.

“The next few months will tell the tale,” Teague said of whether the HIV outbreak has continued to grow under the surface during the pandemic. “Charleston needs ongoing disease testing, and innovative ways to deal with this, certainly, like everywhere else.”

Asked about the complaints about sweeps and too-little attention to unhoused people, Goodwin, Charleston’s mayor, pointed to the city’s Coordinated Action Response Effort office that she started in 2019.

“The truth is — there is not a simple solution,” she said in a statement. “Anyone who tells you otherwise — or offers a quick fix — simply does not understand or is not being honest.”

The statement also notes that the city must also contend with those “who are simply here in our city to break laws and take advantage of our generosity and good graces.”

Charleston’s crime rate is worse than in Baltimore, according to Neighborhood Scout, largely due to property crime.

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