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The utilization of treatment and case management services by HIV-infected youth

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Abstract

Purpose

This article describes the essential components for effective and comprehensive HIV care for youth who have tested positive and have been linked to HIV treatment. Descriptive profile data are also presented that detail the demographics, risk behaviors and health care barriers of youth served in the five Special Projects of National Significance (SPNS), which focused on adolescents and young adults.

Methods

Data presented are from the core multi-site data set, which was standardized across the five youth-oriented SPNS projects. Substance use and mental health symptoms were gathered using the Personal Problem Questionnaire (PPQ) screener, which was an adaptation of the PRIME-MD. In-depth qualitative interviews with enrolled HIV-positive youth were also conducted by several Projects.

Results and conclusions

Medical care alone is not enough and cannot be effective without supportive program components such as flexible scheduling, and a multi-disciplinary team approach that includes assertive case management. Case Managers help enrolled youth with concrete service needs such as housing, emergency financial assistance for food/utilities, transportation, child care, coverage for prescriptions, and public entitlements. They also help isolated youth to connect with a personal support system. Addressing those needs helps to facilitate and reinforce treatment adherence and retention. In addition to other identified needs such as stable housing and transportation, a significant number of enrolled youth self-reported having experienced physical, sexual, and/or emotional abuse in their lives and articulated a need for mental health services. Therefore, effective HIV care for youth must be multi-faceted; it must consist of more than a medical component.

Section snippets

A descriptive profile of AWAC youth: service needs, service utilization, and barriers confronted

The projects identified 107 youths who were enrolled in treatment programs. We present a descriptive profile of this group. Although it cannot be considered representative of the HIV-infected adolescent population as a whole, this group of treatment enrollees can serve to illustrate some of the characteristics that can be expected of adolescents presenting for HIV treatment.

Discussion and lessons learned

The AWAC treatment programs developed a number of treatment elements that proved to be important to the primary care of HIV infected youth.

Acknowledgements

This work was supported by grants from: HIV/AIDS Bureau, Health Resources and Service s Administration, U.S. Department of Health and Human Services, and the Kaiser Family Foundation.

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