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The Boston HAPPENS Program: Needs and Use of Services by HIV-Positive Compared to At-Risk Youth, Including Gender Differences
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Objective: The Boston HAPPENS (HIV Adolescent Provider and Peer Education Network for Services) Program is a linked services network of care for HIV-positive, homeless, and at risk youth in Metropolitan Boston funded by the Special Projects of National Significance Program. This report studies the needs and use of services by HIV-positive youth compared with negative and untested at-risk youth, including gender differences.

Design: Providers collected information prospectively at outreach and services encounters, including demographic information, risk behaviors, and service utilization data.

Results: Youth (N=1044) were 19.6±3.0 years old; 38% male; 43% youth of color; and 4% self-identified as gay/lesbian/bisexual and 11.0% as homeless and/or runaway youth. HIV-positive clients (N=26) were more likely to use a range of network related health services. HIV-positive young women were more likely to report previous pregnancy (21% vs 5%, p=0.04) or sexual contact with high risk partners such as an injection drug user (57% vs 6%, p=0.0009), an HIV-positive person (p<0.00001), or survival sex (33% vs 8%, p=0.04) than the other young women. HIV-positive young men were more likely to be youth of color (75% vs 43%, p=0.04) and self-identify as gay or bisexual (42% vs 4%, p=0.005), and to report same sex partners (80% vs 29%, p=0.03) and substance use (100% vs 26%, p=0.006) than other young men. Youth seen at an outreach site were 10 times as likely to access medical care through the program (95% CI, 6.9–14.6).

Conclusions: HIV-positive youth are accessing coordinated care and there are gender differences in the needs for services. Health care policies should facilitate the development and evaluation of comprehensive, youth-specific health services for these hard to reach populations. (Authors)
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A program of the U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration, Center for Mental Health Services