Linkage to care for HIV-positive adolescents: A multi-site study of the Adolescent Medicine Trials Units of the Adolescent Trials Network

Abstract

Purpose: To understand linkage to care practices at sites providing clinical services to newly diagnosed HIV-positive adolescents. Methods: Qualitative analysis of detailed interviews conducted with 28 personnel involved in linkage to care at 15 sites providing specialty care to HIV-positive adolescents. Results: We showed that multiple models exist for linkage to care, and that both formal and informal community relationships are important for successful linkage to care. Stigma was seen as a universal issue, enhancing the importance of the balance of confidentiality and social support. Barriers to care, such as mental health issues, substance use, and transportation, are common. Conclusions: We conclude that the complexity of linkage to care requires thought and planning as HIV testing is expanded to lower-risk populations.