Hepatitis C is a public health crisis in both developing and developed countries. Direct acting antiviral therapies have revolutionized the fight against Hepatitis C, making the worldwide eradication of the disease feasible. However, screening and access to care for vulnerable patients – especially for patients experiencing homelessness – are lacking. Homelessness exacerbates the effects of Hepatitis C, leading to poor health outcomes for individual patients and high costs for health providers and taxpayers. One potential solution is investing in affordable housing and the housing first model that provide the stability needed to address both acute and chronic health conditions, including Hepatitis C. Partnerships between patients and providers facilitated by supportive housing can benefit individual outcomes and decrease the financial and social costs to communities.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Objectives: (1) To examine whether homelessness predicted earlier resumption of substance use after inpatient detoxification; and (2) to seek evidence concerning the impact of post-detoxification stabilization programs on homeless and housed persons in relation to recurrent substance use. Data Sources/Study Setting: Prospective six-month cohort of 470 addicted persons entering a publicly-funded urban detoxification program. Study Design: Survival analysis methods were used to determine the association between homelessness, stabilization program use, and time to recurrent substance use. Data Collection/Extraction Methods: The main analyses rely on baseline and six month interviews using standardized instruments. Additional analyses include interviews obtained after six months, and statewide administrative records of recurrent detoxification. Principal Findings: Among 254 persons available at six months, 76% reported recurrent substance use. Homeless persons not using stabilization programs experienced the greatest hazard of return to substance use after detoxification, Hazard Ratio (HR) 1.26, 95% CI (0.88,1.80). Homeless persons using these programs had the lowest rate of return to substance use: HR 0.61, 95% CI (0.40,0.94). A similar impact of stabilization programs was not seen among housed subjects. Analyses suggest that subjects available at six months were representative of the entire cohort. Conclusions: Post-detoxification stabilization programs were associated with improved outcomes for homeless addicted persons. / 2031-01-01

The use of sport to tackle a variety of social challenges, a strategy referred to as Sport for Development and Peace (SDP), is on the rise. Despite the recent attention given to the social value of sport to society few studies have investigated the relationship between sport, homelessness and poverty. This investigation explores such a relationship and in doing so helps to address a gap in existing sport in society research. In addressing such a gap this exploration takes its lead from Amartya Sen’s capability approach. Informed theoretically and methodologically by the capability approach this research provides an original thesis that considers the ways in which sport contributes to the expansion of the human capabilities of a select number of homeless street soccer players. The purpose of this thesis is to provide an original piece of research that advances our knowledge of sport in society and more specifically sport, homelessness and poverty. It uses a qualitative, collective case study design in which the participants of two social enterprises, which use street soccer to help overcome homelessness and its associated effects, were interviewed in order to understand the specific ways in which street soccer has helped to develop capabilities in the sense that Sen used this term. During the research process the notion of pathways with different entry and exit points emerged and became central to this work. This thesis has built on this idea through its use of two street soccer organisations: The Homeless World Cup and Street Soccer (Scotland), each of which operates at a different stage of the homeless pathways. By understanding sport as capabilities this research differentiates stages in the development of capabilities and identifies specific capabilities built through sport as separate to those built through the use of street soccer in either a sport plus and plus sport sense. With the increasing use of sport in development initiatives across the globe, it is both timely and necessary to consider new ways of understanding its social benefits. In the capability approach there exists the potential not only to better understand the ways in which sport interacts with and shapes individuals, communities and societies but also to better inform the use of sport for the purposes of development in the future. This thesis proposes that understanding sport as the development of capabilities is useful not least because of the universality of the new approach to considering and appreciating the social benefits gained in and through sport but also to alert sociologists and other disciplines to the value of Amartya Sen’s capability approach.

The homelessness phenomenon is extreme exposure of indigence and social preclusion. Much of world has been fighting with this problem for many years and our society is not exception. Also in our country the subjects exist which are becoming either volunteer or under the pressure of circumstances socially outcasted. It is livehood of individuals without home who are not able to solve their situation adequately without assistance of others. Hence they search various forms of social remedy. The term homelessness denotes summation of dealings and actions, causes and consequences which leads to loss of upcountry (home), life surenesses or more precisely to social preclusion. In my thesis I tried to zoom homelessness problems without prejudice and to find out public opinion on this. It should serve as basis for further research in this scope and increase the degree of awareness about the homelessness problems.

La question « SDF » est étudiée au sein de deux paradigmes : l’approche critique qui insiste sur les phénomènes de domination sociale et l’approche interactionniste qui souligne les adaptations successives que les individus mettent en oeuvre. Ces adaptations sont étudiées à travers des situations particulières dans lesquelles l’identité de sansdomicilese construit et une carrière se dessine. Cette carrière est abordée soit comme une carrière de désocialisation dont la clochardisation constitue l’horizon, soit comme une carrière de survie dont le maintien de soi forme la perspective quotidienne et biographique. Dans ce cadre, les travaux menés sur les questions de la « sortie » et du « chez soi »ouvrent la voie à une approche renouvelée du maintien de soi au-delà de la gestion de la « face » en situation. C’est dans cette perspective que s’inscrit notre ethnographie des pratiques numériques comme supports pratiques du maintiende soi. L’expérience de l’errance est traversée par un certain nombre d’épreuves rassemblées dans une lutte pour le maintien de soi. Ainsi, le maintien de soi est à la fois une préoccupation quotidienne et une question biographique englobant les temporalités passées, présentes et futures. Il se travaille dans le quotidien de la survie mais aussi dans le travail de mémoire, de présentation, d’expérimentation et de projection de soi. Si la lutte contre la déprise est un travail essentiellement invisible, les pratiques numériques, observées dans l’écologie de l’activité, offrent une entrée pourl’observation et l’analyse. Ainsi, les pratiques numériques supportent, dans le quotidien de la survie, les démarches d’accès aux droits et la négociation de marges d’autonomie. Elles sont également un support des sociabilités familiales etamicales. Les pratiques numériques, à l’interface entre le privé et le public permettent aux personnes à la rue de s’aménager des temps et des espaces pour se soucier d’elles-mêmes. Enfin, notre recherche montre que les pratiques numériques constituent un support ambivalent, tantôt habilitant, tantôt disqualifiant. En effet, le support ne s’actualise pas nécessairement positivement et peut, au contraire, se retouner contre le sujet, alimentant l’émiettement identitaire et renforçant les sentiments de solitude et d’indignité. / Homelessness is studied within two paradigms: the critical approach, which emphasizes the phenomena of social domination and the interactionist approach that underlines the successive adaptations that individuals implement. Those adaptations are studied through particular situations within which the "homeless" identity is built and a career takes shape. That career is looked at either as a un-socialization career or as a survival career in which self-preservation forms a daily and biographical perspective. In this context, working on issues such as "Getting off the streets" and "Home" paves the way for a renewed approach to self-preservation beyond situational facework. In this perspective, our ethnography of digital practices forms a practical support for self-preservation. Our fieldwork within social support structures shows that all the people surveyed, despite their heterogeneity, experience wandering as an intimate and social experience, and as a form of extreme precariousness which is lived between street and assistance, and marked by a self-weakening and an alteration of the capacity to look to the future. This experience is punctuated by many trials, gathered in a struggle for self-preservation. Self-preservation is then both a daily concern and a biographical question encompassing past, present and future temporalities. It is a work in the daily reality of survival but also through a memory work, selfpresentation, self-experimentation and self-projection. If the struggle against disengagement is almost invisible, digital practices offer a new approach for observation and analysis. Digital uses make it possible to access to rights and margins of autonomy. They also support friendship and family links. Between private and public life, digital uses allow homeless people to set up times and spaces to care about themselves. Eventually, our study also shows that digital uses create an ambivalent form of support: sometimes enabling, sometimes disqualifying. Indeed, it can turn against the subject, feeding identity crumbling and strengthening the solitude and unworthiness feelings

The presented diploma thesis "Holy and unholy homeless" deals with finding the inspiration for social work with individuals - the homeless people, in the emerging phenomenon of Christian monasticism. The hypothesis of the diploma thesis, the existence of the possibility of drawing lessons for today's social work, confirms in the end in three areas and inspiring circuits. Powered by TCPDF (www.tcpdf.org)

Background: Street-involved youth are known to be at a greatly increased risk of HIV and sexually transmitted infections (STIs); however, the role that environmental and structural factors play in driving disease transmission risk among this population has not been thoroughly examined. Methods: The At Risk Youth Study (ARYS) is a prospective cohort of homeless and street-involved youth between the ages of 14 and 26. From September 2005 to October 2006, participants completed a baseline questionnaire which elicited information regarding sexual activity, injection and non-injection drug use, addiction treatment experience, encounters with police and security guards, and health service utilization. Environmental and structural correlates of number of recent sex partners were identified using quasi-Poisson regression. Factors independently associated with consistent condom use were also examined using logistic regression. Results: Among 529 participants, 415 (78.4%) were sexually active during the past six months, of whom 253 (61.0%) reported multiple sex partners and 288 (69.6%) reported inconsistent condom use during this time period. In multivariate logistic regression, homelessness and self-reported structural barriers to accessing health services were inversely associated with consistent condom use. In multivariate analysis, living in a shelter, hostel, or single room occupancy hotel was positively associated with greater numbers of recent sex partners. Structural factors that were associated with number of sex partners included having a warrant or area restriction that affects access to health services, and for males, being accosted by the police. Conclusions: Unstable housing, homelessness, and structural factors related to the criminalization and displacement of street-involved youth were associated with an increased risk of HIV and STI transmission, even after extensive adjustment for sociodemographic and individual level characteristics. These findings suggest that both environmental and structural factors influence the spread of HIV and STIs, and point to the need for environmental-structural interventions to reduce the burden of these diseases among this population. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

As the population ages and income disparities increase, issues affecting older adults and marginalized individuals are examined more frequently. Despite this, little attention is paid to the community experiences of women over the age of fifty who face marginalization, criminalization and homelessness. This study is an institutional ethnography of older marginalized women in Ottawa, focusing on their identities, lives and their experiences of community life. Its findings are based on ethnographic fieldwork as well as interviews with 27 older marginalized women and 16 professionals working with this group. The women described their identities, social networks, daily activities and navigations of their communities as well as the policy and discursive framework in which their lives are situated. Regardless of whether the women had housing or were staying in shelters, upheaval, uncertainty and change characterized their experiences in the community, reflecting their current circumstances, but also their life courses. Their accounts also revealed how, through social support, community services, and personal resilience, older marginalized women negotiate daily life and find places and spaces for themselves in their communities. As an institutional ethnography, this research foregrounds participants’ responses, framing these with theoretical lenses examining mobilities, identity, social capital, governmentality, and stigma. Specifically, it uses the lenses of mobilities and identities to understand the nature of their community experiences, before moving outward to examine their social networks and the world around them. Governmentality theory is also used to describe the neoliberal context framing their community experiences. The study concludes with a reflection on the research and a set of policy recommendations arising from the study.

M.A. (Social Work) / This study was based on qualitative research methodology and was basically exploratory, seeing as though it was aimed at the gathering of knowledge and insight. The study can also be defined as a self-initiated research as a result of the researcher's interest in the phenomenon of homelessness. As a result of the extensiveness of the problem, the study was limited to the homeless that stay in care centres in the Genniston area, of which there were four, during April 1994, when the study was undertaken. A thorough literal study was conducted, which brought to light that other countries, especially America, have already undertaken various studies to research the phenomenon of homelessness. The cross-sectional survey was chosen as the research design, which also generated hypotheses. Interview schedules were used in the collection of data and respondents were selected through systematic sampling from the target group which consisted of the total number of inhabitants of the four care centres.

Urban inequality has emerged as one of the dominant themes of modern life and globalization. More than three million people experienced homelessness in the United States last year; in Miami-Dade, more than 15,000 individuals were homeless. Surviving extreme poverty, and exiting or avoiding homelessness, involves negotiating a complex mix of public and private assistance. However, a range of factors influence what types of help are available and how they can be accessed. Frequently, larger social structures determine which resource are available, leaving many choices entirely out of the individual’s control. For single men, who are ineligible for many benefits, homelessness can be difficult to avoid and even harder to exit. My study seeks to better understand how adult, minority men living in extreme poverty in Miami-Dade negotiate their daily survival. Specific research questions address: Do black and Hispanic men who are homeless or at risk of homelessness have different personal characteristics and different experiences in avoiding or exiting homelessness? How does Miami’s response to extreme poverty/homelessness, including availability of public benefits and public and private service organizations, either maximize or constrain the choices available to this population? And, what is the actual experience of single, adult men who are homeless or at risk of homelessness, in negotiating their daily survival? A mixed methods approach combines quantitative survey data from 7,605 homeless men, with qualitative data from 54 semi-structured interviews incorporating the visual ethnography techniques of Photo Elicitation Interviewing. Results show the differences experienced by black and Hispanic men who are poor and homeless in Miami. Findings also highlight how the community’s official and unofficial responses to homelessness intersect with the actual experiences of the persons targeted by the policies and programs, challenging preconceived notions regarding the lives of persons living in extreme poverty. It adds to the existing body of literature by focusing on the urban Miami context, emphasizing disparities amongst racial and ethnic groups. Findings are intended to provide an empirically grounded thesis that humanizes the subjects and illuminates their personal experiences, helping to inform public policy around the needs of extremely poor populations.