ADOLESCENT MEDICINE TRIAL NETWORK FOR HIV/AIDS

背景：青少年艾滋病毒和艾滋病现在主要归因于危险的性行为或物质使用。 无家可归的青年感染率很高，他们有其他风险因素，如生存性行为或多个伴侣。 目的：1）拉金街青年中心（LSYC）-加州大学弗朗西斯科分校（UCSF）合作将招募，登记和维持一个由75名艾滋病毒+街头参与青年组成的队列，进入弗朗西斯科青少年医学试验单位（AMTU），为他们提供行为和临床艾滋病毒研究; 2）LSYC-UCSF合作将招募，登记和维持一个由125名艾滋病毒阴性但有风险的街头青年组成的队列进入旧金山弗朗西斯科AMTU，为他们提供艾滋病毒初级预防和临床研究; 3）LSYC-UCSF合作将继续扩大弗朗西斯科的HIV +有色人种青年的入学率。对ATN的贡献：弗朗西斯科的LSYC为离家出走和流落街头的青年提供了17年的全面服务，自1990年以来为艾滋病毒阳性青年提供了全面护理。 自1998年以来，LSYC，UCSF青少年医学部和UCSF儿科艾滋病计划合作，在标题IV资助的艾滋病毒+青年护理中心。 拉金街善后和辅助护理（ACAC）计划在旧金山弗朗西斯科的一个地点为艾滋病毒阳性青年提供全面的医疗保健，住房，病例管理和社会支持服务。 LSYC有着成功的街头青年合作纵向研究的历史。 方法：在1998/1999财政年度，艾滋病咨询委员会方案向82名艾滋病毒阳性街头感染者提供了全面服务。 除一人外，所有人都是通过高风险性行为或物质感染的。 通过一项广泛的外展方案确定了青年，该方案增加了外展和少数民族青年的艾滋病毒检测。 在1999/2000财政年度的头8个月中，对216名青年进行了检测，血清阳性率为6%。 LSYC每年还为2000多名艾滋病毒阴性但有风险的青年提供连续服务，其中400多人在LSYC诊所接受医疗护理。 研究者：主要研究者、共同研究者和项目协调员在多中心合作研究、基于队列的研究、街头青年研究、青少年医学和艾滋病毒初级保健方面拥有丰富的经验。创新/环境：LSYC一直是照顾难以接触人群的典范。 LSYC为艾滋病毒阳性和有风险的无家可归青年提供一整套服务，这些服务在一个对青年友好的环境中提供。

Background: Adolescent HIV and AIDS are now primarily attributable to risky sexual behaviors or substance use. Infection rates are high among homeless youth who have additional risk factors, such as survival sex or multiple partners. Aims: 1) The Larkin Street Youth Center (LSYC)- University of California, San Francisco (UCSF) collaborative will recruit, enroll, and maintain a cohort of 75 HIV+ street involved youth into the San Francisco Adolescent Medicine Trials Unit (AMTU) to provide them with access to behavioral and clinical HIV research; 2) The LSYC-UCSF collaborative will recruit, enroll, and maintain a cohort of 125 HIV negative but at-risk street involved youth into the San Francisco AMTU to provide them with access to on primary prevention of HIV and clinical studies; 3) The LSYC-UCSF collaborative will continue to expand enrollment of HIV + youth of color in San Francisco. Contribution to the ATN: LSYC in San Francisco has provided comprehensive services to runaway and street youth for seventeen years, and comprehensive care to HIV + youth since 1990. Since 1998, LSYC, the UCSF Division of Adolescent Medicine, and the UCSF Pediatric AIDS program have collaborated in a Title IV funded center for the care of HIV+ youth. The Larkin Street Aftercare and Assisted Care (ACAC) program provides comprehensive medical care, housing, case management, and social support services to HIV+ youth at a single site in San Francisco. LSYC has a history of successful collaborative longitudinal research of street youth. Approach: The ACAC program provided comprehensive services to 82 HIV+ street-involved clients in FY 98/99. All but one were infected through high risk sexual behaviors or substance. Youth are identified through an extensive outreach program, which has increased outreached and HIV-testing by minority youth. 216 youth have been tested in the first 8 months of FY99/00, with a 6% rate of seropositivity. LSYC also provides a continuum of services to over two thousand HIV-negative but at-risk youth every year, over 400 of whom receive medical care at the LSYC clinic. Investigators: The Principal investigator, co-investigators, and project coordinator have extensive experience in multi-site collaborative research, cohort-based research, research with street youth, adolescent medicine, and HIV primary care. Innovation/Environment: LSYC has been a model in care of hard-to-reach populations. LSYC offers a complete continuum of services for HIV + and at risk homeless youth which are provided in a youth friendly environment.