Boston HAPPENS Program: HIV-positive, homeless, and at-risk youth can access care through youth-oriented HIV services.
The Boston HAPPENS Program is a collaborative network of care consisting of multiservice outreach agencies; community health centers; and hospitals for HIV-positive, homeless, and hard-to-reach youth. In four years of data collection, the program served more than 2,000 youth, including 54 HIV-positive youth. The youth were 19.9 +/- 2.9 years old; 64 percent female; 45 percent youth of color; 11 percent gay/lesbian, bisexual, or undecided; and 13 percent homeless or runaway. Homeless youth were much more likely to have been involved with a mental health system (47% vs. 12%, P < 0.001), the criminal justice system (20% vs. 2%, P < 0.001), high-risk sexual behaviors (21% vs. 3%, P < 0.001), and substance abuse (25% vs. 6%, P < 0.001) than were other youth served by the program. Comprehensive networks of care offering a continuum of services and a variety of entry routes and types of care sites are needed to connect under-served youth to health care. Outreach and human immunodeficiency virus (HIV) counseling and testing services can offer important portals of entry into health services for at-risk youth. Support services such as outreach, case management, and mental health services are needed to complement medical services by all youth at-risk for contracting HIV. Support services are necessary for the initiation and retention of youth in care so that early case identification and complex treatment regimens can be initiated and tailored to the individual.
Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. elizabeth.woods@tch.harvard.edu
Elizabeth R
ER
Woods
Cathryn L
CL
Samples
Maurice W
MW
Melchiono
Sion Kim
SK
Harris
D000293:Adolescent; D016497:Adolescent Health Services / Q000191:economics; D001900:Boston; D019090:Case Management; D003159:Community-Institutional Relations; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology; D006297:Health Services Accessibility; D018453:Homeless Youth / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D015397:Program Evaluation; D011634:Public Health; D019037:Urban Health Services / Q000191:economics