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


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.
Johnson
Robert L
RL
Department of Pediatrics, Division of Adolescent and Young Adult Medicine, UMDNJ-New Jersey Medical School, Newark, New Jersey 07101, USA. rjohnson@umdnj.edu
Botwinick
Geri
G
Sell
Randall L
RL
Martinez
Jaime
J
Siciliano
Carl
C
Friedman
Lawrence B
LB
Dodds
Sally
S
Shaw
Kimberly
K
Walker
Lynn E
LE
Sotheran
Jo L
JL
Bell
Douglas
D
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D000328:Adult; D019090:Case Management / Q000706:statistics & numerical data*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000628:therapy*; D006301:Health Services Needs and Demand; D006798:Housing; D006801:Humans; D008297:Male; D010348:Patient Care Team; D010379:Peer Group; D012309:Risk-Taking; D012944:Social Support; D019966:Substance-Related Disorders / Q000150:complications; D011795:Surveys and Questionnaires; D014187:Transportation of Patients; D014481:United States