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."