For one regular visitor to the Youth Services Bureau's downtown Ottawa drop-in centre, it started off as a small problem -- more an annoyance than a real concern. Her mouth piercing had become infected, but alongside the other challenges that came with being homeless -- finding food and shelter, simply surviving-it didn't seem to warrant too much attention. In time, though, that small problem blossomed into a full-scale crisis. A trip to the emergency room led to a long-term hospital stay. The infection had spread and, even after treatment, she still lives with its effects.

Andrea Poncia, an HIV/AIDS educator who works at the bureau, thinks things would have turned out differently if the YSB had an integrated health service in place at the time.