Children’s Hospital of Boston has implemented the Boston HAPPENS Program, an innovative project that advances knowledge about health services utilization and provides a network of care for homeless, at-risk, and HIV-positive youth across 8 agencies.

Boston HAPPENS provides a city-wide network of culturally and developmentally appropriate adolescent-specific care as illustrated in the box on the right. This innovative network of youth-specific care offers a continuum from street outreach to referral and HIV specialty care that crosses institutional barriers. In order to optimize care for the target population and find solutions to known service gaps, Boston HAPPENS also supports and links health care agencies and adolescent-specific providers.

Specifically, health care professionals and trained peer leaders link HIV-positive youth to primary and referral care by multi-disciplinary teams. Three hospitals, three neighborhood health centers, and two multi-service youth outreach agencies provide outreach, counseling and testing support services, case management, episodic, primary, and HIV care, coordinated care, and treatment. Through this network, Boston HAPPENS integrates HIV care into adolescent comprehensive care settings, with close ties to HIV specialists in the Boston Pediatric and Adult AIDS Clinical Trial Units. Additionally, particular emphasis is placed on connecting homeless youth from the Boston Common area’s "Combat Zone" to care.

41 HIV-positive youth and 1,995 at risk youth participated in regular care through February 1998. Overall, 2,036 clients have accessed the program’s network of coordinated services, with 1,829 youth receiving medical services and 1,210 mental health services. Of the youth served by the program, 61.8% received HIV risk assessment, 55.0% received HIV pre-test counseling, 43.4% received HIV testing, 23.2% received referrals to medical appointments, and 30.6% received HIV post-test counseling.

Young people have been involved in the development and functioning of the Boston HAPPENS Program from its inception. For example, a Youth Advisory Board helped to develop a youth brochure and to provide feedback regarding the program. After an initial peer leadership training, several peer leaders have worked as youth staff for the program. These young people provide outreach at the street level, in waiting areas/drop-in centers, and at community events. Support is provided for them, along with training, to process issues that arise and enhance personal development. Moreover, youth-oriented counseling and testing has proven to be essential for identifying HIV-positive youth and connecting youth to care and early intervention.

For further information contact Elizabeth R. Woods, M.D., M.P.H., Children’s Hospital, Division of Adolescent/Young Adult Medicine, 300 Longwood Avenue, Boston, MA 02115, 617.355.6495, HAPPENS@a1.tch.harvard.edu.

Adolescent SPNS/Fax is produced by The Measurement Group for the HRSA Special Projects of National Significance Program. Editorial comments should be made to The Measurement Group at 5811A Uplander Way, Culver City, California 90230, 310.216.1051, 310.670.7735 (fax), ghuba@TheMeasurementGroup.com. To be added to the distribution list, contact The Measurement Group. Please feel free to photocopy and distribute Adolescent SPNS/Fax throughout your organization. Subscriptions are free.

Back to Adolescent SPNS/Fax Directory