The Walden House Young Adult HIV project: meeting the needs of multidiagnosed youth.

Walden House, Inc.'s Young Adult Human Immunodeficiency Virus (HIV) (YAH) project is supported by the Special Projects of National Significance Program of the Health Resources and Services Administration (SPNS-HRSA). This project has served 512 high-risk young people (ages 13-25 years), 101 of them living with HIV/acquired immunodeficiency syndrome (AIDS). The YAH project offers treatment services and a coordinated support system to adolescents and young adults who are in need of HIV/AIDS services as well as behavioral health care; all clients suffer from multiple diagnoses. This system includes medical and psychological assessment, referral and coordination; therapy and counseling services; transportation; peer education and counseling; legal information and referral; and case management for long-term options. YAH provides HIV testing access, pretest and posttest counseling, HIV and sexually transmitted disease education, HIV-positive speakers as role models, and community-based outreach. YAH also serves as a resource within Walden House to spur enhancement of service provision for HIV care as well as programming for young people. The emphasis is on providing a comprehensive continuum of services, with the case manager and peer staff coordinating services to try to meet the diverse needs of each client. The complexity and intensity of the target population's needs challenge the traditional models of care. This project provided almost 4 h daily of cost-effective rehabilitation programming to each client, increased participants' self-reported measures of well-being, and increased staff's ability to deal with HIV issues.