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Intervention Provision Characteristics in 10
Adolescent-Targeted Projects for HIV/AIDS Services: A Cross-Cutting Evaluation of the
Health Resources And Services Administration Special Projects of National Significance
Program
Executive Summary
In aggregate, over a period of two and one-half years, the 10 adolescent SPNS projects have provided more than 13,000 service interventions to more than 2,000 youth, including 229 individuals known to be HIV-positive. Across the 10 projects, a range of services has been provided to the youth, in a diverse range of settings.
The interventions provided by the adolescent SPNS projects appear to be matched appropriately to the needs of the clients served. For example, youth identified as HIV-positive tended to receive a greater proportion of interventions focused on treatment and case management compared to youth not identified as HIV-positive. In contrast, youth not known to be HIV-positive tended to receive a greater proportion of interventions focused on prevention and risk reduction than the youth known to be HIV-positive.
The intensity of program involvement also varied depending on the clients’ HIV status. For example, youth identified as HIV-positive received many more interventions than youth not identified as HIV-positive. Overall, the total number of service sessions recorded in the evaluation data system was higher on the average for youth known to be HIV-positive compared to those whose HIV status is unknown. As examples of specific service types that reflected this difference, HIV-positive youth received a higher average number of interventions by physicians, nurses, case managers, counselors, peer counselors, and teachers than youth not identified as HIV-positive. Youth with HIV received more HIV risk assessments, were tested more frequently, and received post-test counseling more frequently than non-positive youth. Positive youth received more medically-oriented interventions, as well as more individual counseling and crisis intervention sessions than youth not identified as such. Although in many cases the percentage of HIV-positive youth who received at least one of these service sessions was lower than the percentage of youth of unknown HIV status, it has been demonstrated that the youth who were engaged in these services returned for multiple visits and appear to be successfully engaged in care.
The results summarized in this report suggest that among these 10 adolescent SPNS projects, youth known to be HIV-positive tend to have been already tested and identified as such before enrolling in the services of the SPNS project. This finding is consistent with results presented in the second report of this series, "Enrolled Clients in 10 Adolescent-Targeted Projects for HIV/AIDS Services," which demonstrated that youth known to be HIV-positive were likely to enter the adolescent SPNS programs through agency outreach efforts as opposed to direct community or "street" outreach.
Qualitatively, the 10 adolescent SPNS projects have identified a number of service intervention successes. Programs successfully engaged youth in care and provided services using youth-sensitive models. The programs have identified a number of lessons learned along the way, including program elements that may be especially key to maintaining youth in care.
This report describes the specific interventions provided to young people by the 10 adolescent SPNS projects. The fourth volume in this series is a technical report that builds on the technical appendix to Chapter 4 of this report. The technical volume will provide more sophisticated statistical models and a number of analyses presented in this report will be expanded to account for variation among adolescent SPNS clients in terms of age, HIV status, and other important factors.
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