Innovative Services for Young Women: Addiction, Mental Health, and HIV

G. J. Huba, Ph.D., The Measurement Group, Culver City, California; T. Bettencourt, BAY Positives, San Francisco, California; R. Burch, Ph.D., YouthCare, Seattle, Washington; R. Feudo, Ph.D., Greater Bridgeport Adolescent Pregnancy Project, Bridgeport, Connecticut; B. Greenberg, Ph.D., Walden House, San Francisco, California; G. Remafedi, M.D., Minnesota Youth and AIDS Project, Minneapolis, Minnesota; A. Schneir, M.P.H., Childrens Hospital Los Angeles, Los Angeles, California; M. Sturdevant, M.D., University of Alabama, Birmingham, Alabama; S. Tierney, Ed.D., Health Initiatives for Youth, San Francisco, California; M. Wallace, Indiana Department of Health, Indianapolis, Indiana; E. Woods, M.D., Children’s Hospital of Boston, Boston, Massachusetts; K. Marconi, Ph.D., Health Resources and Services Administration, Rockville, Maryland; B. Singer, J.D., Health Resources and Services Administration, Rockville, Maryland; R. Brady, Health Resources and Services Administration, Rockville, Maryland; A. T. Panter, Ph.D., University of North Carolina; A. K. Kawata and L. A. Melchior, Ph.D., The Measurement Group, Culver City, California.

INNOVATIVE SERVICES FOR YOUNG WOMEN: ADDICTION, MENTAL HEALTH, AND HIV

The Health Resources and Services Administration (HRSA) Special Projects of National Significance (SPNS) Program recently funded a group of 10 national demonstration projects targeting adolescents and youth for HIV/AIDS services. The projects focus on services for HIV-positive youth and those youth at-risk for HIV. All of the projects provide services to young women, and many have a special focus on issues specifically related to substance abuse, mental health, and HIV/AIDS among young women. The models range from traditional university and hospital-based medical models which include specific outreach components designed to attract young women into care (such as those at Children’s Hospital Boston, Childrens Hospital Los Angeles, and the University of Alabama at Birmingham) to community-based services designed by and for youth. The Los Angeles and Boston projects provide health, mental health, and substance abuse services within the context of outpatient medical clinics. Two San Francisco-based projects (Bay Area Young Positives and Health Initiatives for Youth) utilize a peer-driven model in which young people design and implement services for youth. Other programs, such as the Bridgeport (Connecticut) TOPS program, Seattle YouthCare, the Indiana Youth Access Program and the Minnesota Youth and AIDS Project, use peer elements within a broader therapeutic context. Whereas the majority of these projects focus on outpatient services, one project – Walden House – provides residential substance abuse treatment to young women (and young men) living with HIV and has a substantial mental health component in its therapeutic community. Many of the programmatic elements in these model programs are specifically designed for young women. The 10 projects participate in a national cross-cutting evaluation which allows data from these diverse models to be pooled so that issues relating to young women can be examined in a common way across the projects. In addition to providing youth-friendly and appropriate services, the adolescent-focused projects also focus on disseminating information about their models to the service provider, scientific, and policy communities. One implication for service configuration is that for this group of young women, medical care cannot be separated from or only weakly linked to drug treatment and mental health. In order to succeed, these services must be offered as one integrated care plan.

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