CARING WITHOUT AN ADDRESS: BONDING, THERAPEUTIC ITINERARIES AND CARE PRODUCTION FOR PEOPLE EXPERIENCING HOMELESSNESS

Abstract

This chapter analyzes health care for people experiencing homelessness through three dimensions: bonding, therapeutic itineraries, and the ability of health networks to adapt to ways of life that do not follow conventional service organization. It is a narrative literature review based on Brazilian studies on Primary Health Care, Street Clinic teams, access, stigma, harm reduction, and care coordination. The aim is to discuss how territorial practices can produce continuity despite mobility, lack of a fixed address, difficulties storing medicines, and trajectories marked by social exclusion. Studies show that documentation requirements, rigid schedules, prejudice, and fragmented networks distance users from services and favor late use of emergency care. In contrast, active outreach, flexible schedules, territorial follow-up, and trusting relationships increase the possibility of longitudinal care. Street Clinic teams emerge as a strategic device, but their reach depends on integration with primary care units, mental health services, hospitals, social assistance, and rights protection policies. Caring without an address therefore requires replacing expectations that users adapt to services with health care organization capable of recognizing real trajectories and sustaining bonds across them.