Every day youth are forced to leave their homes, or choose to leave because remaining is unacceptable. While on the streets, youth often engage in a variety of high-risk behaviors, such as substance abuse, survival sex, and needle sharing. Consequently, these youth are particularly vulnerable to HIV infection. YouthCare targets street-involved, homeless, and sexual minority youth in Seattle, Washington. The program provides a comprehensive system of care, including HIV test counseling, outreach services, risk reduction counseling, intensive case management services for youth with HIV, prevention case management services for youth at high risk for HIV infection, and recreational activities.

Between December 1993 and February 1998 the YouthCare project made 4,750 contacts among its target population of youth, and enrolled 1,080 clients. The chart on the right describes the services that these clients have been referred to either within or outside of YouthCare.

Project PIE involves youth in many aspects of its implementation. Seattle’s Positive Youth (SPY) has been created by HIV-positive youth for HIV-positive youth with the assistance and support of Project PIE. This support group promotes both the opportunity for socialization as well as a forum for getting treatment information and discussing care alternatives. SPY youth also help disseminate information about their lives as HIV-positive people to local, state, and federal policy makers. Additionally, the program relies on the feedback of youth to help guide its services. This feedback includes focus groups, consumer satisfaction surveys, anecdotal reports from youth and case managers, and the involvement of youth in the project’s design.

YouthCare has established a system of free and anonymous adolescent-specific HIV antibody test counseling in Seattle, which provides immediate access to prevention and early intervention case management services. In addition it has had a profound effect on the system of care for HIV-positive, non-disabled people in Seattle’s King County by participating in the establishment of a system of service coordination. Project PIE staff provide responsive, innovative case management through referral to services, transportation to appointments, and will attend appointments with clients when requested. YouthCare has been a model program for the integration of care services and prevention education services and has been able to keep the majority of youth who have applied for services actively enrolled in case management.

Currently, YouthCare provides the only adolescent-specific HIV services available in the King County area. There has been no continuum of HIV services for youth in Seattle, apart from YouthCare’s coordination of services for individual youth. Thus, in the last three years the largest and most significant change in Seattle’s continuum of care for young people living with HIV/AIDS has been the very existence of YouthCare’s Prevention, Intervention, and Education Program (Project PIE).

For more information contact Lee Trevithick, YouthCare Project, 2500 NE 54th St., Suite 100, Seattle, WA 98105, 206.694.4500, ext. 1211, ltrevithick@msn.com.

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