Prior research suggests that the survival of adolescents living with HIV/AIDS is substantially decreased by delays in the delivery of needed health care and services. As a result, the major goals of the University of Minnesota’s Youth and AIDS Project (YAP), in collaboration with its Adolescent Early Intervention Program, are 1) to provide outreach and comprehensive, coordinated, family-centered care to all Minnesota youth with HIV and 2) to encourage other local, state, and national agencies to expand their provision of comprehensive, coordinated care to HIV-positive adolescents and their families.

This project, which targets all 13-22 year old HIV-positive youth reported to the Minnesota Department of Health (MDH), works as follows. Youth with HIV infection are identified through the existing system of mandatory, name-linked reporting of HIV cases to the MDH. When the names are reported, the MDH sends an Adolescent Early Intervention Specialist to assess health care needs and to link youth with comprehensive care at YAP. In addition, traditional public health services are offered, such as education and partner notification.

The YAP model meets the needs of all known HIV-positive Minnesota youth by

• providing outreach to them soon after diagnosis;

• linking them to health care systems early in the course of the disease;

• offering comprehensive medical and psychosocial services to reduce morbidity and mortality; and,

• carefully evaluating outcomes in relation to the participants’ characteristics.

Furthermore, the client, family members, case managers, referral agencies, and other multidisciplinary team members collaborate in the development of a care plan, which continuously evolves with the client’s needs.

As a result, HIV-positive adolescents and their families are offered a comprehensive array of services, including primary and secondary prevention services, case management, help with entitlement programs, social, educational, and vocational support, external referrals for clinical trials, food, shelter, clothing, emergency funds, and condoms. Since the inception of the program, the largest categories of completed services were case coordination, access to entitlement programs and social services for persons with HIV/AIDS, primary and subspecialty medical and dental care, health education and risk reduction, and mental health and chemical dependency services.

The YAP program has developed intervention strategies for linking HIV-positive adolescents to care. Moreover, the program has generated important new information about the barriers to health care services for youth, and ways to overcome them.

For further information contact Gary Remafedi, M.D., M.P.H., University of Minnesota Youth and AIDS Project, 428 Oak Grove Street, Minneapolis, MN, 55403, 612.627.6820, remaf001@maroon.tc.umn.edu (e-mail).

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