Providing clinical opportunities for youths affected by HIV.

Individual counseling, as invaluable as it is for HIV-affected youth, is just one forum in which young people can receive clinical assistance. The youth-centered programs noted previously and others carried out in various agencies around the country offer HIV-affected youth an opportunity to receive clinical experiences while focusing on their strengths and interests. A nonthreatening atmosphere in which many children are invited to participate is essential for helping young people feel comfortable and connected to the agency. When children develop friendships through the agency, they can begin to feel less alone in their situation and more willing to reach out to others--clinicians and peers--for help. An increased trust in the agency can help HIV-affected young people maintain an ongoing connection to services and open the door to traditional counseling. As children become more engaged in the agency and begin to develop a sense of ownership, they may want to take on more responsibility. Leadership programs that focus on young people's skills and talents can help establish the agency as a place that is safe for youths on their own terms. That may involve activities such as older children serving as mentors for younger ones, performing community projects in their neighborhoods, doing outreach to help connect more people to the programs, or designing and running their own conferences for youth. Collaboration with other agencies for special projects can help link children to additional programs and to other youth, thus decreasing their isolation. Childhood and adolescence is a time of rapid changes accompanied by emotional fluctuations. Young people feel emotions intensely, but often lack the cognitive ability necessary to articulate them. When a young person is coping with the illness or death of a parent from AIDS in addition to all the pressures and changes in life, the experience of growing up is even more difficult and complicated. The emotional flux, confusion, and life transitions can lead to impulsive and self-destructive behavior. But childhood and adolescence is also a time of heightened energy, creativity, resilience, and hope. Programs for HIV-affected youth need to balance the attention paid to the challenges they face and the strengths they possess. When allowed to grow and shine, affected young people may begin to express some of their emotional needs. Caring workers can then help them make sense of their experiences and mature into the successful adults they all have the potential to become.