title: Creating Systems Change to Support Goals for HIV Continuum of Care: The Role of Community Coalitions to Reduce Structural Barriers for Adolescents and Young Adults.
abstract: Routine population-wide HIV screening, early linkage and long-term retention in healthcare for HIV-infected individuals are key nodes of the HIV continuum of care and are essential elements of the National HIV/AIDS Strategy. Despite this, up to 80% of youth are unaware of their HIV infection status and only 29% are linked to HIV healthcare; less than half are engaged in long-term HIV healthcare, and far fewer maintain viral suppression. To fill this gap and to address the national call to action to establish a seamless system for immediate linkage to continuous and coordinated quality healthcare after diagnosis, this paper describes the processes and mechanisms by which the SMILE Program worked within the infrastructure of the ATN-affiliated Connect to Protect®(C2P) community coalitions to address structural barriers that hindered youth in their communities from being tested for HIV infection or linked and engaged in healthcare after an HIV positive diagnosis.
authors.affiliation: Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA.
authors.forename: Cherrie B
authors.initials: CB
authors.lastname: Boyer
authors.affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore, MD.
authors.forename: Bendu C
authors.initials: BC
authors.lastname: Walker
authors.affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore, MD.
authors.forename: Kate S
authors.initials: KS
authors.lastname: Chutuape
authors.affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore, MD.
authors.forename: Jessica
authors.initials: J
authors.lastname: Roy
authors.affiliation: Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
keywords: Adolescents/Young Adults; Community Coalitions; HIV Continuum of Care; Structural Barriers