LAUSR

Background To underlie new practices towards health promotion and well-being for homeless people and drug users, it is necessary to broaden the focus to interpersonal relationships throughout their life cycle. The Community Treatment is an innovative approach, as it proposes a change in perspective. Few studies have highlighted the process of human development and interpersonal relationships as a resource for new health practices. Objectives To understand how interpersonal relationships and substance use are modified throughout the life cycle of homeless people in urban regions of São Paulo. Methods This study followed a qualitative methodology and took place in the biggest city of Brazil, São Paulo, in 2017/2018. Three approaches were used: participant observation, formal interviews with key informants (n=19) and homeless adults substance users (n=14) using the timeline technique, with a total sample of 33 participants. All interviews were audiotaped and observations were registered in field diaries. The audio files were full transcribed and submitted to content analysis. All procedures were aligned to COREQ (Consolidated Criteria for Reporting Qualitative Research) and SRQR (Standards for Reporting Qualitative Research) guidelines. Results Findings of the timeline technique and observational study show that the life cycle of homeless people and substance users are marked by several family bonds broken in two moments: childhood and adolescence. Living in the streets and drug use are connected with these broken ties. Themes related to LGBTT experiences appeared with considerable frequency and are also connected to these ruptures. Conclusions Triangulation of data indicate that it is necessary to consider these broken bonds when creating new interventions for homeless drug users. The Community Treatment is an approach that considers all vulnerabilities found in the life cycle of this populations.