Programs  >  Health Services

Medical Clinic: For all youth 24 and under on Sutter Street

Everyone deserves good health and kids, in particular, should be able to count on the resilience of their younger age to carry them through the harshest of times. But life on the streets quickly reduces the chances that a homeless or at-risk youth can maintain any sense of physical well-being. The lack of shelter, the stress of street life, the inability to stay clean—these make youth on the street much more susceptible to illness than the rest of us. And because many at risk youth are forced into the sex trade in order to survive, or resort to substance abuse to abate their despair, homeless youth are also susceptible to much more serious health issues including tuberculosis, hepatitis, and HIV infection.

Larkin Street Youth Service’s Medical Clinic on Sutter Street targets all of these health care problems while also promoting general wellness, health education and prevention. Operated in partnership with the San Francisco Department of Public Health, the Clinic is conveniently located next door to the Drop-In Center in San Francisco’s Polk Gulch neighborhood. The Larkin Street Medical Clinic is many kids’ first contact with our services and maintains a full medical staff including a medical doctor, two family nurse practitioners, two registered nurses, and a medical assistant.

The Clinic is open five days a week and does not require an appointment. On a drop-in basis, youth come for physicals, pregnancy tests, TB and Hepatitis screening, and prescriptions. They also receive treatment for common illnesses that would otherwise go unaddressed until they progressed to serious levels, possibly requiring more painful and expensive emergency treatment. Medical care is delivered respectfully with specialized knowledge of the challenges faced by young people on the streets. This approach builds trust that encourages youth to seek further services offered by Larkin Street to help build a foundation and successfully live independently off the streets.

Each year, Larkin Street’s clinic provides critical health services to approximately 700 youth without access to medical care.

HIV Specialty Clinic

Larkin Street takes a leadership role in providing HIV services for at-risk youth and the vulnerable youth living on San Francisco’s streets, who are at extremely high risk for HIV infection.

Larkin Street has a well-developed HIV prevention program for homeless youth, but for those who are already infected, we offer state-of-the-art medical care targeted specifically to HIV positive youth who must manage their HIV status while also rebuilding their lives after homelessness.

Youth accessing services at the HIV Specialty Clinic are offered more than just basic health care. Larkin Street’s HIV Specialty Clinic also provides treatment advocacy to make sure youth receive all the HIV services they need, medication monitoring to ensure that they are sticking to the HIV drug regimens that keep them strong, and access to clinical trials that provide new treatments that may eventually help other youth struggling to recover from life on the streets.

Mental Health and Substance Abuse Services

A significant number of the runaway, homeless and at-risk kids accessing services at Larkin Street are dually diagnosed with both mental health and substance abuse issues. Depression, post-traumatic stress disorder, and suicide attempts are all common mental health issues among homeless youth. While some youth on the streets suffered from mental health issues even before they left home; others develop emotional difficulties due to the daily threats of violence and exploitation at-risk youth experience living on the street. In addition, the combination of abusive or neglectful childhoods with the hopelessness of street life is often so toxic that many of Larkin Street’s youth turn to drug use to self-medicate or escape.

Once a youth’s basic survival needs are taken care of at Larkin Street’s Drop-In Center or Medical Clinic, program staff work with youth to achieve greater stability often with on-going counseling to help them move forward toward productive adulthood. Larkin Street offers an integrated mental health and substance abuse program for homeless youth. This approach is comprehensive, meeting an individual’s needs through a combination of mental health and substance abuse assessments, individual and group counseling, peer-based support, emergency mental health assistance, psychiatric evaluation, and referrals to community providers for longer term care. For homeless youth who also need treatment for substance abuse, Larkin Street offers assessments and intervention activities which encourage youth to engage in longer-term alcohol or drug abuse treatment.

Youth enter Larkin Street’s Mental Health and Substance Abuse Services from any of the other Larkin Street programs. Intensive case management is available to help youth navigate Larkin Street’s continuum of services, as well as San Francisco’s network of community providers ensuring that their mental health and substance abuse needs are met.

Larkin Street’s Mental Health and Substance Abuse Services give youth the crucial and necessary support that allows them to make peace with their painful pasts and look forward to happy futures.

Approximately 1,000 youth annually participate in mental health and/or substance abuse services at Larkin Street.

“Streets and speed have got me down. Now I’m going to rehab. It feels really good. I’m getting on track.” – Mike, 23

HIV Prevention

Kids living on the streets are at extremely high risk of HIV infection. Without job skills, homeless youth may turn to prostitution to support themselves. They may seek to escape depression and their sense of hopelessness through drug use. Both prostitution and drug use significantly increase the risk of HIV infection. And exploitive pasts, common among homeless youth, are often linked to risky behaviors on the part of youth which can result in additional risks of HIV exposure.

Larkin Street offers at-risk youth a positive path to bring them off the streets, help them rebuild their lives and gain the skills and knowledge they need to protect themselves from exposure to HIV by participating in our comprehensive HIV prevention program. The at- risk youth Larkin Street Youth Services serves are highly diverse—in age, in racial and ethnic background, in socioeconomic status. To meet their unique and individual needs, Larkin Street offers a range of HIV prevention and education services throughout all of our youth programs including individual outreach services, one-on-one risk reduction counseling, conveniently-accessible drop-in groups, ongoing classes and workshops, and employment training to give them safe options for supporting themselves.

Larkin Street was the first site in San Francisco to offer youth-friendly HIV testing more than 20 years ago. Larkin Street’s goal is that all of the youth participating in programs will know their HIV status. We believe this is an important basis for protecting themselves if they are not HIV positive as well as key knowledge for the protection of others if they are HIV positive. Today, we test nearly 400 kids annually.

We offer all of our interventions, including HIV prevention, from a harm reduction perspective. Harm reduction is a nonjudgmental philosophy that allows young people to have input into their own recovery plans and gives them skills to prevent HIV no matter where they are in their journey off the streets. With Larkin Street’s HIV prevention services, kids can change their behaviors, maintain their health, and focus on the bright futures that lie ahead.

Last year, more than 1,000 youth participated in HIV prevention activities at Larkin Street.