Thanks to the tireless work of SPH-B faculty member Alison Greene, Ph.D. fostering community partnerships, people living unsheltered with HIV and Hepatitis C (HCV) in Indiana have a greater chance at receiving low-barrier quality medical care.
Associate professor in the Department of Applied Health Science (AHS), Greene was appointed as Director of Research for the Rural Center for AIDS/STD Prevention (RCAP) effective this September. Greene also recently acquired one-year partial funding from the federal Health Resources and Services Administration (HRSA) in the amount of $308,324 for the project entitled, “Street Medicine Intervention for People with HIV who are Unsheltered.” Partially supported by RCAP, Greene is partnering with IU Health-Positive Link (IUHPL) to bring medical services and staff to the street outreach team that exists as part of community partner Connection Cafe based in Fayette County, IN.
"This grant will allow us to increase service capacity by adding medical staff and services to the Cafe’s current street outreach team, which is comprised of incredible staff with lived experience who are skilled at meeting people where they’re at," says Greene. "This is intended to be a four-year HRSA initiative, and if the federal funding comes through our goal is to expand our geographic reach by adding five more rural counties to the seven that the Cafe’s outreach team currently serves."
During an RCAP-funded study in 2024 assessing intentions among Cafe and street outreach participants, Greene says only 28.6 percent of people who knew their status to be positive for either HIV or HCV were linked to care.
"Accessing medical care is hard for those with resources and nearly impossible for those who are battling a range of social determinants of health," says Jill Stowers, director of IUHPL. "Developing a medical care plan in partnership with the patient and providing the resources they need to navigate that care can make a tremendous impact in ending the HIV epidemic in Indiana."
Partnership with the Connection Cafe was established in 2019 with Director Charmin Gabbard to address the high number of opioid-related overdose deaths and substance use-related issues in Fayette County at the time, according to Greene. The Cafe, which serves as a regional recovery hub, remains a crucial conduit to bringing services to people in need and promoting health equity.
"The traditional systems and processes that are required to access heath services are often major barriers and don’t allow us to reach folks who are unhoused and in need of care," says Greene. "Our collaboration with the Cafe has been an incredibly rewarding partnership that has allowed us to do meaningful work and implement low-barrier responsive services that have met-and are continuing to meet- community need."
Stowers says that the HRSA grant will allow IUHPL to respond to the health needs of those diagnosed with HIV or HCV in the homeless communities through outreach teams. IUHPL will also provide access to virtual care, eliminating the additional obstacle of traveling long distances to see a specialist.
"In this project, we will provide the medical navigation and care for people living with HIV and HCV that are connected through the street outreach process," says Stowers. "We will also have a nurse who will embed with the Connection Cafe team to ensure immediate needs are addressed and there is a public face meeting people where they are."
With the upcoming Ryan White Distinguished Leadership Award Ceremony hosted by RCAP on Saturday, December 6, 2025, Greene says the Ryan White story is as relevant now as it ever was.
"Stigma and discrimination are big barriers to seeking care. We hear from folks we serve all the time, whether related to HIV care or substance use disorder treatment, how they will seek help and face stigma among service providers or in different types of settings," shares Greene. "Ryan White’s story is a reminder of having the courage to combat stigma and discrimination and is an incredible model of what can be accomplished as a result of that courage."
For more inspiring stories about SPH-B students, faculty, and staff making a difference, visit go.iu.edu/48bx.