A model for adolescent-targeted HIV/AIDS services: conclusions from 10 adolescent-targeted projects funded by the Special Projects of National Significance Program of the Health Resources and Services Administration.

This article describes a model of service for youth living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and youth at high risk for HIV, based on the lessons learned from a set of innovative service projects funded by the Health Resources and Services Administration Special Projects of National Significance (SPNS) Program. Although each project has a unique focus, all collectively seek to enroll youth with HIV into care through new or existing HIV service networks, and direct recruitment via street outreach and other similar methods. The use of various outreach methods tends to yield different patterns of engagement of youth in services. An ideal approach may use a combination of complementary outreach methods. Data at both the national and local levels point to five major elements that capture the innovations of the collective service model: (a) peer-youth information and dissemination; (b) peer-youth advisory groups; (c) peer-youth outreach and support; (d) professional, tightly linked medical social support networks; and (e) active case management and advocacy, for individual clients as well as the programs themselves, to link the various components together. One of the most important factors in the model's success is that youth and professionals share an equal partnership in all stages of program design, planning, and implementation. Youth and professionals each share their expertise in a dynamic process. In addition, active case management is crucial, not only to ensure that clients receive needed services, but also to ensure that the programs themselves run in a coordinated, tightly linked way. Given needs of adolescent clients and existing adult-oriented service networks, the use of active case management and the active participation of youth in the services system are critical.