Conference Abstract

Raising Community Awareness About Adolescent HIV Risk: Development Strategies to Improve Access to Health Care

Authors: Lawrence C. Shulman, Rudy Feudo, Michele G. Shedlin, Sandra Vining

Bridgeport, CT is an old New England industrial city in economic decline, with high rates of unemployment, poverty, drug use, school dropout, teen pregnancy, STIs, and a large adolescent group at-risk for HIV. The Greater Bridgeport Adolescent Pregnancy Program (GBAPP), building on its skills in sex education, pregnancy and STI prevention, developed a teen-focused early intervention and prevention program for youth at-risk for, or living with HIV, utilizing an innovative community outreach model to improve access to care for primarily Black and Hispanic adolescents. This model was adapted from a highly successful, on-going Women's Project which focused on the service and personal needs of street prostitutes. Staff for TOPS (Teen Outreach and Primary Services) were hired with strong culturally and ethnically sensitive and appropriate outreach experience and strong ties to "the street". A group of Peer Educators were employed part-time to complement the outreach team and help build a better bridge of trust among community youth to encourage participation in TOPS. A range of HIV health care services and prevention activities were established by the agency and linkages with other providers were developed for a proposed range of other needed services. A 25 agency Greater Bridgeport HIV/AIDS Care Consortium existed, but it was a loosely structured, weak deliberative body, not decisive and not representative of the target population of minority, hard-to-reach street adolescents. This paper will discuss the developmental strategies for improving linkages with individual agencies and the AIDS Care Consortium to improve the quantity of services and access to those HIV care services for the TOPS population. Agency resistances and responses will be examined. Among the successful efforts have been: a Women's Specialty Clinic for HIV infected women; an adolescent-specific clinic with major emphasis on HIV; an HIV Counseling and Testing program on-site at TOPS to provide greater confidentiality than at the Health Department program which was avoided by adolescents; and parallel Women's and Adolescent's clinics in the South end of town. Issues of achieving a balance between staff "street smarts" and "professional skills" will be raised, as will the use of leisure time and recreational activities as a program recruitment strategy for these teens.

Lawrence C. Shulman, M.S.W., ACSW
Sociomedical Resource Associates
181 Post Road West, Westport CT 06880
(203) 454-0505
(203 222-0266
lcshulman@juno.com