Adolescent SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Adolescent Care Projects:
Volume 1, Issue 11 (June 19, 1998)

Welcome to Adolescent SPNS/Fax. Each issue highlights findings from the HRSA Special Projects of National Significance (SPNS) Program Adolescent Care Projects. These projects have been funded to target adolescents and youth for HIV/AIDS services. This report is distributed biweekly by facsimile machine and also is available on the World Wide Web at www.TheMeasurementGroup.com. To obtain a fax subscription (at no cost), see the information at the bottom of this page. For more information, contact the HRSA/HAB's SPNS: Room 7A-08, 5600 Fishers Lane, Rockville, Maryland 20857, 301.443.9976.

CHLA Uses High Tech and Peer Oriented Strategies for Youth Programs

Currently, it is estimated that as many as 75% of the youth living with HIV in Los Angeles County are not receiving HIV-related services. Consequently, Childrens Hospital Los Angeles (CHLA), Division of Adolescent Medicine, established an integrated care model for youth with, and at high-risk for, HIV infection. CHLA provides targeted and focused outreach, conducted by peer and professional staff, to subpopulations of youth at greatest risk for HIV — young men who have sex with men and injection drug using youth and their sexual partners.

The CHLA adolescent care project was established to respond to growing concern about the number of youth living with HIV in Los Angeles County without access to health care and treatment. The program model contains five basic components:

• targeted outreach to contact youth living with HIV and youth at highest risk for HIV;

• youth-specific and youth-sensitive health services providing the full scope of services from HIV testing to HIV care;

• youth-specific case management and allied health professional services;

• a youth empowerment program; and

• community trainings and workshops to enhance the expertise of community agency staff.

The project consists of a general medical clinic for youth along with psychosocial services including case management, mental health services, and related ancillary services. From December 1993 through February 1998, 715 young people were enrolled in the project's clinic. 1,683 service episodes were provided to 93 HIV-positive youth, while 1,716 service episodes were provided to 622 youth of unknown HIV status. The chart on the left illustrates the services received by both groups of youth.

One innovative feature of the project is the development of a computer-based referral program, the Computer-Assisted Adolescent Referral System (CAARS), which has been implemented within five youth-serving, community-based agencies in Hollywood and also is available on diskette and on the Internet (www.caars.net). CAARS includes a database of service resources for youth in the Hollywood area. It is organized by type of service, including categories such as shelter, medical, legal, recreational, and mental health services. Response by young people as well as service providers has been very positive. In a 13-month pilot test of CAARS, 2,001 referrals were made as a result of 1,150 inquiries. Users of CAARS thought that: the information provided was excellent (68.4%); the system made it easier to find services (67.4%); the system was easy to use (61.1%).

Peer educators/advocates have joined the project to develop and deliver supportive services for clients. This model is being evaluated to determine whether peer-defined and -delivered services further facilitate the identification, linkage, adherence, and retention of HIV-positive youth in care.

For more information contact Arlene Schneir, M.P.H., Childrens Hospital Los Angeles, P. O. Box 54700, Mailstop #2, Los Angeles, California, 90054, 213.669.2390, aschneir@chlais.usc.edu (e-mail).

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