Philbin, M.M., Tanner, A.E., DuVal, A., et al. The Adolescent Trials Network for HIV/AIDS Interventions, AIDS Education and Prevention (2017), 29(2), 93–104.
This qualitative study examined providers of HIV care for adolescents’ perspectives on linkages and adolescent engagement to: (1) inform programs specifically designed to address barriers for adolescents; (2) inform planning of appropriate resource disbursement; and (3) understand assistance required for identified needs. The authors conducted 183 semi-structured interviews with HIV care providers who treat adolescents (outreach workers, linkage coordinators, clinicians, and social service providers) in 15 clinics across the United States. Interviewees described linkage as a standard procedure that was provided for an adolescent, but did not accommodate the adolescent’s individual characteristics. Linkages were said to occur quickly, typically within a week. Participants described engagement as an individualized process in which the adolescent played an active role—carrying out self-care activities, showing up to appointments, and taking responsibility for housing and work. Interviewees described engagement and the resulting retention as a process that takes place over time and that can be hindered by stigma and difficultly accepting one’s diagnosis. They said that strong adolescent–provider relationships are critical to adolescent engagement, and noted that participation in additional services, including housing and food stamps, was essential to help adolescents to stay engaged in care. The authors concluded that effective linkages and engagement require adolescent services that are easily accessed and sustainable.