Substance misuse and related infectious diseases in a soup kitchen population

Representative samples of female (N = 119) and male (N = 100) guests were s elected at two inner city soup kitchens. In the preceding month, 75% used c ocaine/crack and 25% used heroin/opiates as determined by hair analysis. Re latively few guests (25%) were in substance dependency treatment. Infectiou s disease rates were: HIV (16%), hepatitis B exposure (21%), hepatitis B ca rrier (6%), syphilis exposure (15%). Years of injecting drug use and homele ssness/marginal housing were associated with HIV infection and hepatitis B exposure. Soup kitchens should be prime locations for outreach to cocaine/c rack and heroin users in need of treatment, medical care, and interventions to prevent infectious disease transmission.