Transitioning youths into care: linking identified HIV-infected youth at outreach sites in the community to hospital-based clinics and or community-based health centers

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

doi:10.1016/S1054-139X(03)00159-9

« Previous Next »Journal of Adolescent Health
Volume 33, Issue 2, Supplement , Pages 23-30, August 2003

Transitioning youths into care: linking identified HIV-infected youth at outreach sites in the community to hospital-based clinics and or community-based health centers

Jaime Martinez, M.D.
- Division of Adolescent Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA (J.M., D.B.)
Douglas Bell, Ph.D.
- Division of Adolescent Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA (J.M., D.B.)
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.);
Carl Siciliano
- SafeSpace, New York, New York, USA (C.S., L.E.W.)
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 (J.L.S., R.L.S.)
Randall L Sell, Sc.D.
- Mailman School of Public Health, Columbia University, New York, New York, USA (J.L.S., R.L.S.)
Lawrence B Friedman, M.D.
- Department of Pediatrics, Division of Adolescent Medicine, University of Miami School of Medicine, Miami, Florida, USA (L.B.F.)
Geri Botwinick, M.P.A.
- Mailman Segal Institute for Childhood Studies, Nova Southeastern University, Ft. Lauderdale, Florida, USA (K.S.);
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.

Accepted 29 April 2003.

Abstract

Purpose

To describe and analyze the process of transitioning HIV-infected youths from the point of HIV diagnosis into HIV treatment. Rather than simply offering HIV positive youths a list of referrals, the youth-focused SPNS grantees (AWAC) found it vital that youthS were immediately assisted with linkage to a medical provider.

Methods

From February 1997 to December 2000, 107 identified HIV-infected youths from the five adolescent SPNS projects were surveyed on needs and barriers. The time interval between HIV testing and youth linkage to care was also noted.

Results

Nine percent of youth reported perceived barriers to accessing health care. Perceived needs were identified as Mental Health (44.9%; n = 48); Alcohol and drug treatment (14%; n = 15); transportation to health care settings (40.2%; n = 43); and housing (46.7%; N = 50). At sites tracking linkage to care, the time of being transitioned into a medical setting ranged from 5 to 55 days (average 26 days).

Conclusions

The period of transitioning identified HIV-infected youths into care can be reduced from 1–5 years to as short as 5–55 days. Success with linking these youth to care involves establishing a series of contacts at outreach sites wherein program staff seeks to build trusting relationships with youths, is able to track these youths and identify and address perceived needs.

Keywords: Adolescents, Barriers to care, Engagement, HIV, Stabilization, Transitioning into care, Youth