Cross-Cutting Papers: HRSA/HAB's Special Projects of National Significance Adolescent Care Projects

HRSA/HAB's Special Projects of National Significance Adolescent Care Projects: Cross-Cutting Papers

Characteristics of Youth with, and at High Risk for, HIV: A Risk and Needs Typology
G. J. Huba, Ph.D.; Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; Lee Trevithick, M.A.; Elizabeth R. Woods, M.D., M.P.H.; Eric Wright, Ph.D.; Rudy Feudo, Ph.D.; Steven Tierney, Ed.D.; Arlene Schneir, M.P.H.; Adam Tenner; Gary Remafedi, M.D.; Brian Greenberg, Ph.D.; Marsha Sturdevant, M.D.; Elizabeth Goodman, M.D.; Antigone Hodgins; Michael Wallace; Russell E. Brady; Barney Singer, J.D.; Katherine Marconi, Ph.D.
This paper examines the characteristics of 8,251 participants in 10 service demonstration projects targeted to youth living with, or at risk for HIV. Factors predicting risk behaviors and HIV status were identified. The results permit an estimation of HIV risk from basic information available when youth present for care in community programs.

Service Use Patterns of Youth With, and at High Risk for, HIV: A Care Typology
G. J. Huba, Ph.D.; Lisa A. Melchior, Ph.D.; Elizabeth R. Woods, M.D., M.P.H.; A. T. Panter, Ph.D.; Rudy Feudo, Ph.D.; Arlene Schneir, M.P.H.; Lee Trevithick, M.A.; Eric Wright, Ph.D.; Ramon Martinez; Marsha Sturdevant, M.D.; Gary Remafedi, M.D.; Brian Greenberg, Ph.D.; Steven Tierney, Ed.D.; Michael Wallace; Elizabeth Goodman, M.D.; Adam Tenner; Katherine Marconi, Ph.D.; Russell E. Brady; Barney Singer, J.D.
This paper examines the characteristics of the services provided to 4,679 young people by 10 innovative models of HIV care. The services ranged from outreach to intensive participation in medical treatment. Major typologies of service utilization are derived empirically through exploratory and confirmatory modeling methods.

Service Utilization Levels in 10 Adolescent HIV Care Models
G. J. Huba, Ph.D.; Eric Wright, Ph.D.; Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; Elizabeth Woods, M.D.; Gary Remafedi, M.D.; Lee Trevithick, M.A.; Arlene Schneir, M.P.H.; Brian Greenberg, Ph.D.; Ramon Martinez; Elizabeth Goodman, M.D.; Marsha Sturdevant, M.D.; Rudy Feudo, Ph.D.; Steven Tierney, Ed.D.; Michael Wallace; Russell E. Brady; Barney Singer, J.D.; Katherine Marconi, Ph.D.
The present study examines the relationships between the characteristics of 3,732 young people participating in 10 national HIV service demonstration models and the utilization of various health, psychosocial, and ancillary support services provided by innovative programs.

Retention and Initiation of Services in 10 Adolescent HIV Care Models
G. J. Huba, Ph.D.; Elizabeth Woods, M.D.; Eric Wright, Ph.D.; Gary Remafedi, M.D.; Lisa A. Melchior, Ph.D.; Lee Trevithick, M.A.; A. T. Panter, Ph.D.; Arlene Schneir, M.P.H.; Gilbert Pickett; Marsha Sturdevant, M.D.; Steven Tierney, Ed.D.; Michael Wallace; Brian Greenberg, Ph.D.; Rudy Feudo, Ph.D.; Barney Singer, J.D.; Russell E. Brady; Katherine Marconi, Ph.D.
This paper examines patterns of retention in care and the timing of service initiation among 3,732 youth living with, or at high risk for, HIV who participated in one of ten innovative care models.

The Effects of Case Management on Service Use Rates in 10 Adolescent HIV Care Models
G. J. Huba, Ph.D.; Gary Remafedi, M.D.; Adam Tenner; Larry Shulman, M.S.W.; Lisa A. Melchior, Ph.D.; Eric Wright, Ph.D.; A. T. Panter, Ph.D.; Arlene Schneir, M.P.H.; Michael Wallace; Elizabeth Woods, M.D.; Brian Greenberg, Ph.D.; Lee Trevithick, M.A.; Marsha Sturdevant, M.D.; Rudy Feudo, Ph.D.; Steven Tierney, Ed.D.; Gilbert Pickett; Barney Singer, J.D.; Katherine Marconi, Ph.D.; Russell E. Brady
This paper studies the relationships of characteristics of 3,732 youth to their utilization of case management services in 10 national HIV service demonstration projects, and the impact of case management on utilization of other health and psychosocial services.

Psychosocial Functioning of Youth With, and at High Risk for, HIV: A Detailed Characterization
Lisa A. Melchior, Ph.D.; G. J. Huba, Ph.D.; Lee Trevithick, M.A.; Antigone Hodgins; Eric Wright, Ph.D.; Arlene Schneir, M.P.H.; Rudy Feudo, Ph.D.; Elizabeth Woods, M.D.; A. T. Panter, Ph.D.; Brian Greenberg, Ph.D.; Marsha Sturdevant, M.D.; Gary Remafedi, M.D.; Michael Wallace; Steven Tierney, Ed.D.; Russell E. Brady; Katherine Marconi, Ph.D.; Barney Singer, J.D.
This paper examines the characteristics of more than 360 young people who were administered a detailed psychosocial interview as part of their participation in one of 10 adolescent-focused HIV service demonstration projects.

Impact of Public Presentations Conducted by 10 Adolescent HIV Care Projects
Lisa A. Melchior, Ph.D.; Bill Bourdon; Steven Tierney, Ed.D.; Elizabeth Woods, M.D.; A. T. Panter, Ph.D.; Troix Bettencourt; Rudy Feudo, Ph.D.; Lee Trevithick, M.A.; Marsha Sturdevant, M.D.; Eric Wright, Ph.D.; Arlene Schneir, M.P.H.; Brian Greenberg, Ph.D.; Michael Wallace; Gary Remafedi, M.D.; Russell E. Brady; Barney Singer, J.D.; Katherine Marconi, Ph.D.; G. J. Huba, Ph.D.
This paper examines the different ways that the projects used group presentations and training sessions to provide information about HIV among youth and presents information on their estimated impact during a four-year period.

Models of When in a Service Episode Youth Will Undertake HIV Testing
G. J. Huba, Ph.D.; Arlene Schneir, M.P.H.; Rudy Feudo, Ph.D.; Lisa A. Melchior, Ph.D.; Lee Trevithick, M.A.; Elizabeth R. Woods, M.D., M.P.H.; Brian Greenberg, Ph.D.; Steven Tierney, Ed.D.; Marsha Sturdevant, M.D.; A. T. Panter, Ph.D.; Eric Wright, Ph.D.; Michael Wallace; Troix Bettencourt; Gary Remafedi, M.D.; Barney Singer, J.D.; Katherine Marconi, Ph.D.; Russell E. Brady
This paper examines factors related to the utilization of HIV testing services by youth. Data are used from the service histories of 3,732 young people who received care from 10 national HIV/AIDS demonstration projects.

Effects of Outreach to Individual Youth and Transitions to Enrollment
G. J. Huba, Ph.D.; Lisa A. Melchior, Ph.D.; Rudy Feudo, Ph.D.; Arlene Schneir, M.P.H.; Lee Trevithick, M.A.; Elizabeth Woods, M.D.; Eric Wright, Ph.D.; Marsha Sturdevant, M.D.; Steven Tierney, Ed.D.; Meredith Broome; Gary Remafedi, M.D.; Brian Greenberg, Ph.D.; Michael Wallace; Russell E. Brady; Barney Singer, J.D.; Katherine Marconi, Ph.D.
This paper examines the effects of outreach provided to young people in a set of adolescent projects, and the impact that outreach has had in aiding the transition of adolescents into enrolling in more intensive services.

Level of Burden, Service Use Patterns, and Retention in Services in 10 Adolescent HIV Care Models
G. J. Huba, Ph.D.; Lisa A. Melchior, Ph.D.; Brian Greenberg, Ph.D.; Lee Trevithick, M.A.; Antigone Hodgins; Gary Remafedi, M.D.; Arlene Schneir, M.P.H.; Elizabeth Woods, M.D.; Rudy Feudo, Ph.D.; Eric Wright. Ph.D.; Marsha Sturdevant, M.D.; Michael Wallace; Steven Tierney, Ed.D.; A. T. Panter, Ph.D.; Barney Singer, J.D.; Russell E. Brady; Katherine Marconi, Ph.D.
Recently, there has been interest in clients with co-occurring problems, or “multiple” diagnoses. Of particular interest is the triple diagnosis of HIV status, substance abuse, and mental health problems. This paper examines whether youth with co-occurring therapeutic issues have differential service utilization patterns from those not identified as such. Level of therapeutic burden is defined as the number and severity of significant problems, including being HIV-positive, abusing drugs, and having a mental health problem.

An 18-Month Longitudinal Study of HIV Youth Services in Six Cities
Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; Rudy Feudo, Ph.D.; Elizabeth R. Woods, M.D., M.P.H.; Marsha Sturdevant, M.D.; Arlene Schneir, M.P.H.; Sandra Vining-Bethea; Antigone Hodgins; Brian Greenberg, Ph.D.; Adam Tenner; Yvonne G. Lin, M.S.; Bill Bourdon; Russell Brady; Katherine Marconi, Ph.D.; Barney Singer, J.D.; Carla M. Bann, M.A.; G. J. Huba, Ph.D.
A group of adolescent-focused healthcare providers in six cities were studied to examine changes in the service system for youth with, and at high risk for, HIV infection. The study was designed to determine the type, quantity, and pattern of HIV-related service slots available for youth in each city, barriers that prevent youth from receiving HIV-related services, and the general cohesiveness of the service continuum.

Attitudes about HIV-Related Services for Youth: A Study of Service Providers in Six Cities
Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; Arlene Schneir, M.P.H.; Marsha Sturdevant, M.D.; Rudy Feudo, Ph.D.; Elizabeth R. Woods, M.D., M.P.H.; Sandra Vining-Bethea; Antigone Hodgins; Adam Tenner; Brian Greenberg, Ph.D.; Bill Bourdon; Yvonne G. Lin, M.S.; Russell E. Brady; Barney Singer, J.D.; Katherine Marconi, Ph.D.; Carla M. Bann, M.A.; G. J. Huba, Ph.D.
This paper examines changes in the attitudes of providers of youth health and psychosocial services in six cities about key issues in developing and maintaining services for youth with, or at high risk for, HIV.

The Effects of Psychosocial Counseling and Peer Support Services in 10 Adolescent HIV Care Models
G. J. Huba, Ph.D.; Lisa A. Melchior, Ph.D.; Gilbert Pickett; Eric Wright, Ph.D.; Arlene Schneir, M.P.H.; Rudy Feudo, Ph.D.; Elizabeth Woods, M.D.; Brian Greenberg, Ph.D.; Gary Remafedi, M.D.; Lee Trevithick, M.A.; Marsha Sturdevant, M.D.; Steven Tierney, Ed.D.; Michael Wallace; Ariane K. Kawata; Barney Singer, J.D.; Katherine Marconi, Ph.D.; Russell E. Brady
This paper examines relationships of the characteristics of more than 3,700 youth to the utilization of psychosocial counseling and peer support services in 10 national demonstration projects on HIV/AIDS services. Overall, the result of psychosocial counseling and peer support services is to potentially get youth to utilize more services that they need, such as HIV testing services, and referrals to medical or psychosocial services.

Predicting Substance Abuse Among Youth with, and at High Risk for, HIV
G. J. Huba, Ph.D.; Lisa A. Melchior, Ph.D.; Brian Greenberg, Ph.D.; Lee Trevithick, M.A.; Rudy Feudo, Ph.D.; Steven Tierney, Ed.D.; Marsha Sturdevant, M.D.; Antigone Hodgins; Gary Remafedi, M.D.; Elizabeth Woods, M.D.; Michael Wallace; Arlene Schneir, M.P.H.; Ariane K. Kawata; Russell E. Brady; Barney Singer, J.D.; Katherine Marconi, Ph.D.; Eric Wright, Ph.D.; A. T. Panter, Ph.D.
This paper examines data from 4,111 young men and 4,085 young women participating in 10 HIV/AIDS service demonstration projects. The sample was diverse in age, gender, ethnicity, HIV status, and risk for HIV transmission. Results show that information about sexual and other risk factors is highly predictive of substance abuse issues among youth.

Predicting Risk Behaviors Among Youth with, and at High Risk for, HIV
G. J. Huba, Ph.D.; Lisa A. Melchior, Ph.D.; Brian Greenberg, Ph.D.; Lee Trevithick, M.A.; Rudy Feudo, Ph.D.; Steven Tierney, Ed.D.; Marsha Sturdevant, M.D.; Troix Bettencourt; Gary Remafedi, M.D.; Elizabeth Woods, M.D., M.P.H.; Michael Wallace; Arlene Schneir, M.P.H.; Ariane K. Kawata; Russell E. Brady; Barney Singer, J.D.; Katherine Marconi, Ph.D.; Eric Wright, Ph.D.
This paper examines data collected from 4,111 young men and 4,085 young women to predict the number of HIV risk behaviors coded. The results suggest that information collected from youth about sexual and other risk factors is predictive of concomitant substance abuse issues which also need to be addressed in clinical settings.

Young People and HIV/AIDS: The Need for a Continuum of Care
Elizabeth Woods, M.D., M.P.H.; C. L. Samples; Barney Singer, J.D.; N. P. Peters; Lee Trevithick, M.A.; Arlene Schneir, M.P.H.; Steven Tierney, Ed.D.; Rudy Feudo, Ph.D.; Gilbert Pickett; Eric Wright, Ph.D.; Gary Remafedi, M.D.; Brian Greenberg, Ph.D.; Lisa A. Melchior, Ph.D.; G. J. Huba, Ph.D.
This paper provides a number of recommendations for HIV services for adolescent and young adults, based on the experiences of the HRSA/HAB/SPNS Adolescent Care Models. The paper includes discussion of approaches for connecting youth to care, issues around HIV counseling and testing services for youth, case management, and collaborative care networks for linking youth to comprehensive, multi-disciplinary healthcare.