OBJECTIVE: To put long-term shelter at the disposal of homelessness patients, those recently released from prison and those not fully integrated socially. The main aim is to provide them with health care and to a lesser extent, deal with the problem of drug abuse. Most patients affected by this project are intravenous drug user (IVDU) patients without need for hospitalization. METHODS: Provide patients with one-room flats. Financing can be covered in part or totally, according to the patient's resources, by public funds from both the central government (D.G.S.–Division Sida) and the district governments (Conseil General des Yvelines) via two local associations (le Lien Yvelinois et Info-Soins). The medical and psychosocial follow-up of these patients is assured by the members of Info-Soins and the referral service of hospitals or/and the treating doctor. RESULTS: The experiment began in March 1990. In 1990, two apartments were put at patient's disposal. In 1991, four; in 1992, one. The total number of patients covered so far is nine (some of the original patients have since died). Of the original group of nine, all were drug abusers and four had just been released from prison. All had CD4 count below 200, with AZT and primary prevention treatments. Their follow-up, in comparison with the control group, reveals the following: (1) a net improvement in medical care and treatment, reduction of IVDU, while maintaining a self-sufficient life-style and satisfactory comfort unconstrained by material concerns and (2) no discrimination, as a result of being distributed anonymously throughout society. CONCLUSIONS: Resolution of the housing issue through the dispersed set up of patients in society; clear improvement of medical and psychosocial care, but incomplete resolution of drug abuse. The program's disadvantage is the loneliness experienced by patients, often forgotten by families.
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