Since 1993, the Adolescent Initiative a Children’s Hospital has been a leader in the evaluation, prevention and care of adolescents living with HIV and prevention to high-risk youth. The clinic provides comprehensive, interdisciplinary primary and HIV specialty care. A team of physicians, nurse practitioners, nurses, social workers, peers and mental-health professionals creates a seamless continuum of service. The clinic is nationally recognized as a center for research and treatment, recently participating in two major national research initiatives for adolescents; the Adolescent Trials Network and the Pediatric AIDS Clinical Trials Group.
Adolescent HIV care and services require adolescent-focused, intensive case-management interventions. The number of young people being diagnosed with HIV is growing. These youth present with multiple psychosocial problems such as basic subsistence issues, disclosure, housing, stigma, mental-health issues and lack of social support. The goal for this component of the program is to immediately link youth to care and provide services to help youth become more knowledgeable, self-sufficient and competent in managing their HIV.
The mental health support services made available to youth living with HIV are significant. In addition to on-going individual counseling to the youth, the services have included new patient mental health screening, cognitive screenings, depression screenings and intensive psychiatry assessments and follow-up. We also have a component that looks at the impact mental health has on medication adherence.
The only way we will better understand and develop effective treatments for adolescents infected with HIV is through access to adolescent-specific research. Maintaining the seamless integration of care and access to research is essential. As a unit lf the Adolescent Trials Network, and NIH-funded research network that develops and implements intervention trials for HIV-infected and at-risk adolescents, the Adolescent Initiative provides access to trials that will serve to improve HIV care for adolescents in years to come.The primary mission of the Adolescent Trials Network (ATN) for HIV/AIDS Interventions is to conduct research on promising behavioral, microbicidal, prophylactic, therapeutic, and vaccine modalities in HIV-infected and HIV at-risk adolescents between the ages of 12 and 24.
This research is conducted both independently and in collaboration with existing research networks, including:
Connect to Protect (C2P) is a community-level prevention research project of the Adolescent Trials Network for HIV/AIDS Interventions. The mission is to reduce the HIV/AIDS rates among YMSM and their networks through the collaborative efforts of local communities and health researchers. The key to Connect to Protect’s success is uniting the experience and skills of researchers and other individuals and organizations from the community. These partnerships allow for multiple voices to be heard and for community needs to be kept at the forefront as HIV prevention strategies are developed and implemented. Together, C2P partners are creating a blueprint for community action, designed to transform the physical and social environment in ways that can curb the spread of HIV among youth for the long term.
The Adolescent Initiative has achieved considerable success in outreach and linking youth to care. Much of our success is attributable to our philosophy, which aims to tailor an outreach/linkage response to the individual situation. We ideally provide an opportunity for the adolescent to meet with a Children’s Hospital case manager immediately following a positive test result. Also central to the success of this approach are collaborations with community-based counseling and testing sites providing services to adolescents and young adults. Through these collaborations, we have established a model of care for high-risk and HIV-positive youth, providing an immediate link to adolescent-specific medical care.
Each HIV counseling and testing session includes a review of HIV, transmission, protection, personal risks, recent exposures, social/familial supports, specialized risk reduction planning, safer sex skill building, partner notification counseling, post-test counseling, and distribution of safer sex supplies. In all testing efforts, Rapid HIV testing will be emphasized. In cases where a positive test result is identified, any and all youth are immediately connected to an appropriate HIV specialty care clinic.
This program provides adolescent focused intensive prevention to any youth identified positive or very high risk, for HIV. Youth are guaranteed linkage to state of the art adolescent focused HIV specialty care or if negative adolescent focused Sexual Health Care in the Adolescent Care Center at The Children's Hospital of Philadelphia.