Clinicians practicing in Health Care for the Homeless (HCH) projects1 and others who provide primary care to people who are homeless or at risk of homelessness routinely adapt their medical practice to foster better outcomes for these patients.
Standard clinical practice guidelines often fail to take into consideration the unique challenges faced by homeless patients that may limit their ability to adhere to a plan of care. Recognizing the gap between standard clinical guidelines and clinical practices used by health care providers experienced in the care of individuals who are homeless, the HCH Clinicians’ Network has made the adaptation of clinical practice guidelines for homeless patients one of its top priorities.
The original edition of these adapted clinical guidelines was developed in 2003 by primary healthcare providers representing HCH projects across the United States. These recommendations reflect the collective experience of practitioners with extensive experience serving homeless adults, adolescents and children. Updates were made in 2008 to reflect changes in practice standards for the treatment of sexually transmitted infections (STIs) as well as recommended practice adaptations for the care of homeless patients, alerting clinicians to the strong association between STIs and sexual abuse in this population. The updates included in this 2013 document reflect new treatment guidelines, follow-up recommendations, and expedited partner therapy information in response to increased antibiotic resistance of gonococcal infections.