title: Linkage to care for HIV-positive adolescents: a multisite study of the adolescent medicine trials units of the adolescent trials network.
abstract: OBJECTIVE
  To understand linkage to care practices at sites providing clinical services to newly diagnosed HIV-positive adolescents.
  
  
  METHODS
  Qualitative analysis of detailed interviews conducted with 28 personnel involved in linkage to care at 15 sites providing specialty care to HIV-positive adolescents.
  
  
  RESULTS
  We showed that multiple models exist for linkage to care, and that both formal and informal community relationships are important for successful linkage to care. Stigma was seen as a universal issue, enhancing the importance of the balance of confidentiality and social support. Barriers to care, such as mental health issues, substance use, and transportation, are common.
  
  
  CONCLUSIONS
  We conclude that the complexity of linkage to care requires thought and planning as HIV testing is expanded to lower-risk populations.
authors.affiliation: Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. jfortenb@iupui.edu
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
authors.forename: Jaime
authors.initials: J
authors.lastname: Martinez
authors.forename: Bret J
authors.initials: BJ
authors.lastname: Rudy
authors.forename: Dina
authors.initials: D
authors.lastname: Monte
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000592:standards; D001291:Attitude of Health Personnel; D019090:Case Management / Q000458:organization & administration* / Q000592:standards; D002648:Child; D002986:Clinical Trials as Topic; D003219:Confidentiality; D006679:HIV Seropositivity / Q000523:psychology / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D015337:Multicenter Studies as Topic; D011647:Puerto Rico; D036301:Qualitative Research; D012017:Referral and Consultation / Q000458:organization & administration / Q000592:standards; D057545:Social Stigma; D012944:Social Support; D014481:United States; D055815:Young Adult