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

Johnson, Robert L; Botwinick, Geri; Sell, Randall L; Martinez, Jaime; Siciliano, Carl; Friedman, Lawrence B; Dodds, Sally; Shaw, Kimberly; Walker, Lynn E; Sotheran, Jo L; Bell, Douglas

doi:10.1016/S1054-139X(03)00158-7

« Previous Next »Journal of Adolescent Health
Volume 33, Issue 2, Supplement , Pages 31-38, August 2003

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

Robert L Johnson, M.D.
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, UMDNJ–New Jersey Medical School, Newark, New Jersey, USA (R.L.J., G.B.)
- Address correspondence to: Robert L. Johnson, M.D., F.A.A.P., Professor and Interim Chair of Pediatrics, Department of Pediatrics, UMDNJ–New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07101, USA.
Geri Botwinick, M.P.A.
- Mailman Segal Institute for Childhood Studies, Nova Southeastern University, Ft. Lauderdale, Florida, USA (K.S.)
Randall L Sell, Sc.D.
- Mailman School of Public Health, Columbia University, New York, New York, USA (R.L.S., J.L.S.)
Jaime Martinez, M.D.
- Division of Adolescent Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA (J.M., D.B.)
Carl Siciliano
- SafeSpace, New York, New York, USA (C.S., L.E.W.)
Lawrence B Friedman, M.D.
- Department of Pediatrics, Division of Adolescent Medicine, University of Miami School of Medicine, Miami, Florida, USA (L.B.F.)
Sally Dodds, Ph.D., L.C.S.W.
- Department of Psychiatry and Behavioral Sciences, Women’s Mental Health Programs, University of Miami, Miami, Florida, USA (S.D.)
Kimberly Shaw, Ph.D.
- Mailman Segal Institute for Childhood Studies, Nova Southeastern University, Ft. Lauderdale, Florida, USA (K.S.)
Lynn E Walker, M.S.
- SafeSpace, New York, New York, USA (C.S., L.E.W.)
Jo L Sotheran, Ph.D.
- Mailman School of Public Health, Columbia University, New York, New York, USA (R.L.S., J.L.S.)
Douglas Bell, Ph.D.
- Division of Adolescent Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA (J.M., D.B.)

Accepted 29 April 2003.

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.

Keywords: Adolescent HIV care, Comprehensive care for youth, Health Resources and Services Administration, HIV/AIDS, Special Projects of National Significance, Youth with HIV/AIDS