HIV–the pathogen that causes AIDS– is a virus that works by taking over the body’s immune system. It poses a great challenge to the body’s ability to fight off certain cancers, illness and infections. To combat this disease and its challenges in the St. Louis area, Micheal Edlin founded DOORWAYS with the help of civil volunteers and religious leaders. Originally, it was formed as a hospice to serve those who had no hope of recovery and no support system while facing fatal issues. Now, DOORWAYS has evolved into a safe haven for those who struggle with HIV and the stress that comes with its risks.

“I was, at one point, working with juvenile youth that were going through incarceration and helping them with career services,” DOORWAYS’ Director of Career Services, Gabriel Desme, said. “So, I did a little bit of research on DOORWAYS, and I saw the very united, intermingled kind of community that exists at DOORWAYS. It varies into relief systems, lifestyles, what have you. Everyone seemed to be going in the same direction, pulling in the same way.”

“Housing is healthcare”. That is DOORWAYS’ slogan. It’s the phrase countless tireless staff members live by, and the phrase that has saved the lives of thousands of people struggling with HIV. When someone is faced with a deadly disease, their stress levels rise rapidly. Those who have HIV must face both physical torment and social estrangement all while having to support themselves and their families. DOORWAYS works ceaselessly to provide affordable and safe housing for those who have contracted HIV in order to take the biggest weight off of their patient’s shoulders.

“Imagine if you didn’t have a house, or if your house was in danger, you’d be stressed out,” DOORWAYS’ Vice President of Clinical Services Jess Cox said. “If you don’t have a home, you stress. If you have kids, [affordable housing] is a stress reliever. Stress kills.”

On top of housing, DOORWAYS also distributes federal money to Missouri cities, primarily in the St. Louis area, with a high percentage of residents with HIV, with the exact amount increasing with the percentage of residents who contract the disease. The mayor of St. Louis issues a certain amount of money to the program to be used for patient housing, medical care, and donations of clothing or utilities. Every dollar is given to someone who is struggling with HIV or AIDS.

“The Ryan White CARE Act provides social support and core medical services for people with HIV. That includes things like co-pays for medicines and drugs, transportation to doctors, appointments, housing, food, psychosocial support if people have mental health issues, a whole list of things,” Housing Program Vice President Brenda Malone said. “There are cities that have large amounts of people living with HIV, and those are called TGA (transitional grant areas), and then smaller areas that have lesser folks affected with HIV, called EMAS (eligible metropolitan areas). That’s federal money that gets disbursed to TGAs and EMAS across the United States.”

According to Malone, money and housing means nothing if it isn’t coming from a place of sincerity, and it doesn’t get any more sincere than DOORWAYS’ staff. President, Vice President, Manager, Assistant– no matter the title, everyone who is a part of the organization gives it everything they have in order to relieve their patients of their daily grapple with life. This includes making sure the participants have the opportunity to give feedback on the services they receive.

“We do things like put a satisfaction survey out so that people can anonymously talk about what their experience has been,” DOORWAYS’ Vice President of Participant Experience Tammy Laws said. “[They can tell us] if it’s been positive, they can tell us places where we’ve completely missed the mark. They can tell us the things that are going well, that they really like. They can give us their ideas of what things could help improve.”

Many DOORWAYS participants find themselves in the program after being socially alienated and neglected by those they once depended on. This can make it difficult for them to adjust to the help they’re receiving. DOORWAYS’ social workers know this, and they know that there is always light at the end of the tunnel, even for those who have undergone trauma too great to comprehend.

“Humans are humans, and they’re hard,” Cox said. “A lot of our clients that we serve come from homelessness, and homelessness is a trauma. Working through and helping supporting mental health of people who have been through a lot of trauma over and over and over in their lives, sometimes that’s abuse or neglect, can be really difficult to treat sometimes. We want people to set their own goals, and while we want them to be healthy and we want them to have stable housing, they get to determine what that looks like for themselves. Then we come along and support that as best as we can with the resources that we have.”

Food, water, clothing, and shelter stand as the pillars for a person’s survival; however, the term healthcare is often only regarded as the treatment of illness or injury. For participants in the DOORWAYS healthcare program, it starts with shelter, because if you have nowhere to sleep, you have nowhere to live.

“We wanted to prove that people who do not have stable housing have a much harder time being compliant on medications, getting to their doctor’s appointments, or being healthier in general,” Tammy Laws, Vice President of Participant Experience, said. “So, when we started the Allen House program, we followed what their test results were when they first entered the program, and then we measured them annually. We discovered a 64% viral suppression rate as the baseline, and after six months to a year, we were seeing rates like 91%.”

The staff working in DOORWAYS work collectively for the betterment of their participants. Sharing information and being in constant communication to gain a full perspective of the client, enabling them to make sound and conscientious decisions.

“Collaboration is really important because we are sharing the care of a participant with other staff,” Jess Cox, the Vice President of clinical service, said. “No one is just going to come to our counseling program and just recieve counseling. They’re also living on campus or in an apartment with a case manager, so the case manager might see some things that the counselor doesn’t, and vice versa. And so we work collaboratively together for the care of our participants.”

Recovery is a hard-earned journey. DOORWAYS understands, providing participants with the space to make mistakes and recover at their own pace. Help is offered no matter the person’s past or present circumstances.

“Housing is first,” said Coplima Colquitt, Director of Residential Housing. “We don’t require that you’re sober. We don’t require that you take your meds. We don’t require you to participate in the program.”

At DOORWAYS, the phrase ‘housing is healthcare’ isn’t just echoed: it’s lived. Every participant is housed, and every participant is given a chance to take back control of their life. This organization works to prove that shelter is vital for healing, and caring for health means caring for housing, for it is healthcare.

“Nick, you weren’t here last week,” Avery, a preschooler in DOORWAYS ‘after-school program, cried.

“It just kind of hit me,” DOORWAYS volunteer Nicholas Burton said. “I didn’t notice that I wasn’t there, but the kids noticed. And seeing how much it means to them to have people around, it’s probably the most rewarding part.”

“I like getting to see the impact on the kids,” Burton said, smiling. “That sounds like such a generic answer, but I’ve found that I got the most value when I started going to the family property and volunteering with the kids. It’s great to raise money, but seeing where the money’s going is a lot more impactful.”

Over time, Burton has formed close relationships with the children. Whether it’s the preschooler who loves to do homework with Burton, or the kids who rely on him to help them spell.

“One of my favorite things that has happened was there was this girl, and we had been helping her practice for her spelling bee,” said Burton. “And when she came back, she said she won. It was just so exciting to help her study and practice and then see her win.”

Kids entering DOORWAYS come with their own unique set of obstacles. Burton witnesses this firsthand and has come to understand why the work he and others do isn’t just helpful– it’s essential.

“There are a lot of students there who can read very little or not at all,” Burton said. “So, you see how important it is to
develop people throughout their whole lives. You know, people struggle; everybody knows that people struggle in this world. But spending time with these kids who are just learning how to read makes you very sympathetic to a struggle that you didn’t realize was so prevalent that it’s right in our backyards.”

Volunteers are the backbone of most organizations, and at DOORWAYS, their impact is felt every day. Events such as Friends in Deed or the adoption of a client for the holidays help create a better community with selflessness at the core of their work.

“If you have extra time, you should be using your extra time to do something. I just think it’s everybody’s responsibility to give back,” Burton said,” If you want to live in a better world, you have to help make it a better world. Working with these students– that’s where it starts.”

The work DOORWAYS has done is far from over. In fact, it is rapidly expanding. Extensions on programs and buildings have kept the nonprofit leveling up. Most recently, a freshly-built addition to the main building will soon be a clinic to help upgrade the medical treatment aspect of the program.

“When we built the building, we built it with the intention of having some raw space,” DOORWAYS’ Vice President of Advancement, Jim Timmerberg, said. “So, we didn’t finish this off, and we didn’t know what it was going to be, but now we’ve realized what we’re going to want to put in is a clinic.”

This clinic will help in starting the health care process off early, possibly right when the participant gets to DOORWAYS. An office, a bathroom, and two examination rooms will make up the STI testing primary care clinic. Participants who have just been introduced to DOORWAYS are able to be put on Prep, a pill that prevents individuals from contracting HIV.

“The clinic’s purpose is to do that and to provide health care to the community,” Timmerberg said. “We have a pharmacy that we partner with, and they’re out of New York, and they specialize in serving low-income populations, particularly people with HIV or other complicated medical issues. So we’re excited about this. This will probably come online in September.”

No matter how many changes and upgrades are made, DOORWAYS’ mission will remain to serve the St. Louis community. Part of the way they do this is through medical help. With the hospital and Walgreens in the area closed, the only pharmacy and clinic within three miles is DOORWAYS.

“If you’re low income, you don’t have a car,” Timmerberg said. “You have to rely on public transport, which isn’t always easy. And so we try to make things easier for people so they can access our services.”

Part of planning for the future for DOORWAYS is looking at what worked in the past. Feedback surveys are given to participants annually as well as at each therapy session, personalizing each person’s experience.

“We often try and motivate [participants] to make goals that are helpful for them in changing the environment and the things they’re doing in their lives to be more positive,” Vice President of Clinical Services, Jess Cox, said. “[The clinic] is our next stop on the map of clinical services and DOORWAYS. It will be like a doctor’s office for people.”