Tucked back in the quiet streets of Adams Morgan in Washington, D.C., Joseph's House looks much like every other house on its block. Its nondescript face belies the extraordinary mission of Joseph's House: to provide a home for homeless men with third- or end-stage AIDS.
Eight years ago the community of Joseph's House shifted constantly. Each man who entered the house died within a year, either from a sudden attack of infection or from the slow, predictable process of AIDS itself. "All we could hope to do was stay around and treat the complications of the disease," explains Dr. David Hilfiker, who started Joseph's House in 1990.
Advances in antiretroviral drug therapies now make it possible to treat the disease. These improvements in HIV/AIDS medication complicate Joseph's House mission. "Now we have some people who come in and get better and we have some who come in and get somewhat better, so that they become sort of chronically ill," explains Hilfiker. "They aren't well enough to live independently, but they aren't going to die any time soon."
With up to five of the 11 men at Joseph's House seriously ill at one time, the personal care staff has doubled over the last eight years to 12 full-time employees and four full-time volunteers. Along with private donations, Joseph's House obtains funding primarily through a local D.C. government office, the Agency for HIV/AIDS. "The hardest question for us right now," Hilfiker says, "is what to do when people do get better. Services aren't magically available for them that weren't there a year ago."
"In some sense, we have to discharge them from the house," Hilfiker continues, "because they are too well to be hereand yet we know there's an awfully high risk of relapse. Also, they have become a part of the community and it's sort of like kicking them out onto the street again. It's been a difficult tension for us to live through."
The relationships developed at Joseph's House are as essential a part of its ministry as the medical care. The community of Joseph's House provides shelter and medication for its men in the greater context of an environment that, according to executive director Patty Wudel, seeks to "honor the suffering and isolation each man has experienced in the context of a new family where tenderness and a desire to be present softens the journey."
Approximately one-third to one-half of people with AIDS are either homeless or at imminent risk of homelessness, and prevalence rates of HIV are at least three times higher in homeless populations than in the general population. Despite their disproportionately high risk for HIV infection and transmission, homeless individuals have limited access to preventative and therapeutic HIV/AIDS care. Along with providing the therapeutic care these men so desperately need, Joseph's House enables each man to live the rest of his life with dignity.
"The sense of home is in itself healing," says Wudel, who lives at Joseph's House with the men. "The extended family welcomes even the most broken and unreachable men. They don't have to change much to be present, to belong. In the face of anguish, now free of violence and neglect, we communicate to each man that he matters. He will be mourned."
"Jesus' work was about including the excluded," Hilfiker says. "In one sense that's what we're about here. Not just because Jesus said to care for the poor, but because this is the kingdom of God. You enter into a new place when you are able to enter into the perception that Jesus had about what constitutes the kingdom, what it means to live with that new relationship to yourself and other people and to God."
Beth Isaacson is editorial intern at Sojourners. For more information on Joseph's House or to support its work, contact Patty Wudel, Joseph's House, 1750 Columbia Road NW, Washington, DC 20009; www.josephshouse.org.