HIV INFECTION AMONG STREET YOUTH

HEALTH AND HUMAN SERVICES
DEPARTMENT  OF 
PROGRAMS AND RESOURCES

. t 
'''VJCIS. 
lJd' 
OFFICE OF INSPECTOR GENERAL 
OFFICE OF EVALUATION AND INSPECTIONS 
SEPTEMBER 1990  HIV INFECTION AMONG STREET YOUTH

HEALTH AND HUMAN SERVICES
DEPARTMENT  OF 
PROGRAMS AND RESOURCES

RICHARD P. KUSSEROW 
INSPECTOR GENERAL 
OEI-01-90-00501  SEPTEMBER 1990
 ...   ...   ...   ....    .......    ..........    .........    .........   . .........    .........    .........  .  .........    ........     ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ....    ...   
TABLE OF CONTENTS

INTRODUCTION 
GLOSSARY 
RESEARCH 
SERVICES 
NETWORKING.  INTRODUCTION

This is a companon report to the August 1990 Offce of Inspector General draft report entitled 
mY Infection Among Street Youth" (OEI-01-90-00500). That report found that street youth 
face an enhanced risk of beoming infected with the human immunodeficiency virs, and that 
strctu 
the problem is compounded by researh gaps and by  barers at the local and Federal 
levels. It recommende that the Public Health Service conduct additional research on the 
HI 
causes and results of  infection among street youth. It also recommended that the Office 
of Human Development Servces, in concert with the Public Health Service, implement a plan 
HI 
to curb the spread of  among street youth in five cities with large concentrations of street 
HI 
youth and high rates of  infection. 
Durg 
our research for that study it became clear to us that there was no single dictory of 
progrs sponsored by the Deparent of Health and Huma Services which, either diectly 
or indictly, are adessing the problem. We believe it is importt for researchers and 
servce providers to be aware of the rage of activities sponsored by the Deparent. This 
report provides summar descriptions of and contacts for several initiatives, grants, and other 
resoures. Although the report is focused on the specific problem of my infection among 
street youth, may of the resources listed were designed to addrss larger issues, such as 
infection in genera or the needs of runaway, homeless, or other high-risk youth. We included 
progrs 
these broady tageted  because of their potential impact on the problem at hand. 
Despite our attempt to be inclusive, this may be only a paral listig. It is based entiely on 
responses to our request for information from the Deparent s operating divisions. 
Furermore, it does not include individual listings of broad based progrs, such as 
Medicaid or the Social Services Block Grat. Simiarly, while several ilY-related programs 
whose scope extends beyond strt youth ar included, we could not list all of them. Readers 
should be aware that street youth may also benefit though such programs. 
th 
The listigs are divided into  categories: research, services, and networking. The fIrst 
section descrbes activities whose primar purose is to answer specific questions over a finite 
priar 
time period. The second section describes activities whose  purpose is to give 
dict 
fmancial support to organizations involved in the  provision of services. The third 
section describes activities designed to foster communication and coordiation between 
HI 
people involved in fightig  among street youth. Several projects, especially 
demonstrtion grants, have a nearly equal emphasis on research and services. To avoid 
duplication, however, no project is listed more than once. 
Within the major categories of research and services, listings are 
classifed by subject matter: 
my testing, education and other prevention, tratment of the infected, and basic service 
provision and integrtion. Again, may projects adess more than one subject, but no project 
is listed more than once. The section on networking is divided into external and internal afais.  The descriptions ar primary verbati transcrptions drwn from materials supplied to us by 
the Deparent. In some cases, they have been edte or supplemente by OIG staf for the 
puroses of completeness and coherence. The descrptions were correct as of August 1 , 1990.  GLOSSARY 
The following is a list of abbreviations used in this report: 
ACYF  Admnistrtion for Childrn, Youth, and Famlies 
ADAM  Alcohol, Drg Abuse, and Menta Health Admnistrtion 
AHCPR  Agency for Health Car Policy and Research 
AIS 
Acquired Immunodeficiency Syndrome 
Secta 
ASPE  Assistat  for Planning and Evaluation 
BHCDA  Burau of Health Car Delivery and Assistace 
BHP  Burau of Health Professions 
BHR  Burau of Health Resources Development 
BMCH 
Burau of Maternal and Child Health and Resources Development 
(NOT: Th Bureau was split in the Sprg of 1990, fong the Bureau of Heath Resources Development and 
the Mateal and Chd Heath Bureau. 
CCDPHP  Center for Chronic Disease Prevention and Health Promotion 
CDC  Centers for Disease Control 
CID  Center for Infectious Diseases 
CPS  Center for Prvention Services 
DASH  Division of Adolescent and School Health 
HHS  Deparent of Health and Human Services 
Human Imunodeficiency VlIS

HRSA  Health Resources and Services Admnistrtion 
IHS  Indian Health Service 
Intrvenous 
MCHB  Maternal and Child Health Bureau 
AIS 
NAPO National  Program Offce 
NIA

National Institute on Alcohol Abuse and Alcoholism 
NIID 
National Institute of Allergy and Infectious Diseases 
NICH  National Institute of Child Health and Human Development 
NIDA  National Institute on Drg Abuse 
NIH  National Institutes of Health 
NIMH  National Institute of Menta Health 
OASH  Office of Assistat Secreta for Health 
ODPHP  Office of Disease Prevention and Health Promotion 
OHDS  Office of Human Development Services 
OMH  Office of Minority Health 
OSAP  Office of Substace Abuse Prvention 
PHS  Public Health Service 
SSA  Social Securty Admnistrtion 
SID  Sexually Trasmitted Disease  RESEARCH

SEROPREVALENCE, EPIDEMIOLOGY, AND AIDS CASE SURVEILLANCE 
HIV Seroprevalence Surveys 
HI 
Description:  These sureys ar designed to determne the rate of  infection among the 
population at large and among varous subpopulations. One of those subpopulations is the 
homeless. Curently, 3 of CDC's 10 serosureys of the homeless focus specifcaly on 
blide 
homeless youth. These sureys ar anonymous and  the only information attached to 
HI 
test specimens is age  , race, and pricipal  risks (if known). The CDC hopes to 
grup, sex
ad five more serosureys of the homeless next year. Ten other CDC serosureys relevant to 
street youth are being conducted in juvenile detention facilties and adolescent health clinics. 
Seroepidemiology Branch, Division ofHIY/AIDS, CID, CDC, Atlanta, GA, 30333.
Contact: 
Heterosexual Transmission of HIV and Related Retroviruses 
Nll is funding prospective studies of 2 000 people in Newark and Brooklyn. 
Description: 
The goal is to determne the natue of the epidemic in a population of inner-city heterosexuals 
who do not use intrvenous drgs, and to determne the biological and environmental 
HI 
cofactors associated with  infection. The diectors of these studies ar encouraged to 
include people between the ages of 18 and 21, and may include emancipated minors over 16. 
It is too early to know whether adolescents wil indeed be attracted into this research. 
Epidemiology Brach, Division of AIS, NIID, Nll, 6300 Executive Boulevard, 
Contact: 
, 20895 
Rockville, 
San Francisco Men s Health Study 
This study has the same genera goal as the heterosexual transmission studies 
Description: 
describe above. Gay adolescents and young mae prostitutes wil be included. 
Epidemiology Brach, Division of AIDS, NIAID, Nll, 6300 Executive Boulevard
Contact: 
, 20895 
Rockvile, 
National AIDS Case Surveillance 
All states have regulations requirng health care providers to report all AIDS 
Description: 
diagnoses to state or local health deparents, who pass the information along to CDC. 
Because of the delay between infection and onset of symptoms, this information may be of 
minimal use to those studying HIY in adolescents. 
Sureilance Brach, Division ofHIY/AIDS, CID, CDC, Atlanta, GA, 30333. 
Contact:  BEHAVIORAL AND EDUCATIONAL RESEARCH 
AIDS Prevention for High Risk Adolescents 
HI 
Conducted by the  Center for Clinical and Behavioral Studies, the goal of 
Description: 
ths project is to develop and evaluate an intervention program aimed at reducing high risk sex 
and drg behavior among the runaway and gay youth. The taget population includes 900 
male and female adolescents between the ages of 12 and 17 who seek services at runaway 
shelters or at a unique agency servng gay and lesbia youth. The study is a collaborative 
effort between New York Psychiatrc Institute and four community agencies. The intervention 
imrses 
model  youth in 10 session programs to decrase unsafe behaviors. The intervention 
HI 
focuses on increasing general knowledge about AIDS and transmission of  infection; 
buiidig personal knowledge, such as the adolescents' perception of vulnerabilty to AIDS and 
belief that they can change their behavior in order to protet themselves from infection; 
enhances social skils that can be marshalled in situations with peers to mantan safe sex and 
drg practices and that can be used to create supports which provide access to health 
inormation and health  well as researchers from the Institute 
care. Parcipating agencies as 
have formed a work group to maimize the effectiveness of the intervention in each setting 
and with each population. 
Progr, NI, ADAMH
Offce of AIDS  , 5600 Fishers Lane, Rockvile, MD, 
Contact: 
20857 
HIV in Street Youth: Epidemiology and Prevention 
This study, conducte by the Deparent of International Health at Johns 
Description: 
Hopkis University, wil collect informtion on the cognitive and behavioral antecedents of 
HIY risks among children and adolescents living on the strets of Belo Horizonte, Brazil, and 
Baltimore, MD. 
Health and Behavior Researh Branch, Division of Basic Bran and Behavioral 
Contact: 
Sciences, Basic Prvention and Behavioral Medcine Research Branch, NIMH, ADAMH, 
5600 Fishers Lane, Rockvile, MD' 20857 
Cooperative Agreementfor Multi-Site Trils of Behavioral Strategies to Prevent the 
Further Spread of HIV Infection 
NI 
issued a request for applications in Spring 1990, to conduct a 
Description: 
collaborative study to: 1) develop behaviora intervention strategies for groups of individuals 
at high risk for HIY infection that have not been reached effectively by existing prevention 
and improve the existing educational and mass 
effort; 2) assess existing intervention efforts 
media strategies that have shown some effectiveness; and 3) develop an overall effective 
progr 
intervention  to promote behavior change that wil prevent the further spread of the 
HIYepidemic. Emphasis wil be placed on the development and testing of preventive  interventions in groups at high risk for HI infection, including homeless and runaway 
adolescents. 
Progr, NIM, ADAMH
Office of AIDS  , 5600 Fishers Lane, Rockvile, l\ 
Contact: 
20857 
Public Knowledge, Atttudes, and Behavior Concerning AIDS 
Extrural  Grt 
An AIDS  Research  to the University of Calfornia at Davis
Description: 
wi gather information thugh a national surey and social-psychological questionnaies. 
Areas of knowledge and ignorace wil be identied and reommendations wil be made as to 
effective AIS educational approaches. A longitudial analysis of trends in attitudes, beliefs 
and behaviors wil be completed Target grups include adolescents, blacks and Hispanics. 
Division of Basic Brai and Behaviora Sciences, NIM, ADAMH, 5600 Fishers 
Contact: 
Lane, Rockvile, l\, 20857 
National AIDS Demonstration Research Grants and AIDS Targeted Outreach 
Model Contracts 
Description:  These projects ar evaluating the effcacy of interventions designed to reduce 
risk-tang behaviors by intravenous drg users and their sexual parners. Baseline behaviors 
are determned using the AIDS Initial Assessment form. Follow-up is conducted six months 
AIS 
after intervention using the  Follow-up Assessment form While the NADR program 
was initially focused on adult IV drg users, 160 youth ar now included in the data base. 
Five of the 24 projects have focused some attention on youth in term of outreach, and two 
have developed specific interventions for multi-problem street youth. Under the National 
HI 
Data Coordnation and Evaluation Center program a contrtor collects  antibody status 
data frm the National AIDS Demonstration Researh grantees. 
Community Researh Branch, Division of Applied Research, NIDA, ADAMH 
Contact: 
5600 Fishers Lae, Rockvile, MD, 20857 
WARN and Abt, Inc. 
These contrctors are evaluating outrach and intervention strategies focused on 
Description: 
HI, 
two groups of women at risk for  including adolescent women. The two target groups are 
prostitutes and the sexual parers of intravenous drg users. Like the other AIDS Targeted 
Outrach Model projects, these contrctors are collectig and analyzing pre- and 
post-intervention data using the AIDS Initial Assessment and AIDS Follow-up Assessment. 
Community Researh Branch, Division of Applied Research, NIDA, ADAMH 
Contact: 
5600 Fishers Lane, Rockvile, MD, 20857  Evaluation of Community Intervention for Multi-problem Street Youth at Riskfor 
AIDS 
Description:  This contrt, scheduled to sta in the Summer of 1990, wil support research on 
high risk youth,  HI/AIS,  and drg abuse, by: collectig information about multi-problem 
street youth from a varety of soures; conducting ethnographic studies concerning health 
riskig behaviors of multi-problem strt youth; identiying the economic and institutional 
resoures which are requir to work with these youth; developing and testig methods of 
reachig, counseling, and reucing risks though effort specific to those needs of 
multi-problem youth; identiying characteristics of sta reuired for effcacious intervention 
centrze 
with these youth; and providing a  management and coordinatig function for the 
results and fidigs of the project and the resoures, material, and data generated. 
Community Research Brach, Division of Applied Research, NIA, ADAMH 
Contact: 
5600 Fishers Lae, Rockvile, MD, 20857 
Circle 
This contrctor is operatig in Washington, DC, testing the effects of an
Description: 
progr 
education and outreach  for juvenile offenders and high risk youth. Over 
HI/AIS 
400 adolescents wil be located and provided educational services by this contractor. The 
impact of ths model is being assessed by comparng youths who parcipate in either 
standad or enhanced interventions. The intervention cUIculum is designed to be interactive 
and to elicit as much information as possible from the adolescents themselve$, rather than
burg 
them with "facts." A personal choice theme is followed thoughout in order to 
highlight individual responsibilty for behavior. It is hoped the exercises and role plays 
contaed within this education progr wil contrbute to permanent positive behavior 
changes that wil prolong and enhance the life of adolescents at risk for HIY infection. 
Community Researh Branch, Division of Applied Research, NIDA, ADAMH 
Contact: 
5600 Fishers Lae, Rockvile, MD, 20857 
AIDS Community Outreach Demonstration Project 
Run by the University of Texas Health Science Center in San Antonio, this 
Description: 
project wil implement and evaluate an AIDS education and counseling program The target 
drg 
populations are  abusers, their mates, prostitutes, and runaways. The subjects wil be 
stada 
randomly assigned to  or intensive counseling and outcomes wil be compard. 
Community Research Branch, Division of Applied Research, NIDA, ADAMH 
Contact: 
560 Fishers Lae, Rockvile, MD, 20857  AIDS Outreach to IV Drug Users, Sex Partners and Runaways 
Ths project is being conducted by the Psychology Deparent at California 
Description: 
State University at Long Beach. It wil develop and evaluate AIDS outrach and education 
strategies. Prgram activities include counseling and referr for runaways, and antibody 
testing and distrbution of AIDS information and materials. 
Community Research Brach, Division of Applied Research, NIA, ADAMH 
Contact: 
560 Fishers Lae, Rockvile, MD, 20857 
HIV Community Demonstration Projects 
ar 
These seven projects  flexible, community-based research efforts for the 
Description: 
development, implementation, and evaluation of interventions to decrease the probabilty of
HI  progrs 
transmission in a community. The  began on a small scale in FY 1985, and 
dited 
initially  their prevention efforts to men who have sex with men. Subsequently, the 
progrs 
have been designed to reach and change the behavior of other "hard to reach" 
groups at risk of HI infection, such as men who have sex with men but do not admt to being 
homosexual; IV-drg users not in treatment; women who are the sexual parers of these two 
risk youth, such as runaways. These projects are curently 
groups; prostitutes; and high-
developing joint research protocols which include stadadize instrments for conducting 
process, formative, and outcome evaluation. The projects in Chicago, Denver, Seattle, and 
Dallas have research questions specific to street youth. 
CPS, CDC, Atlanta, GA, 30333. 
Contact: 
Evaluating Effective Communication Strategies for Health Information to High
Risk Youth Outside of School 
HI 
This is a two year contract with S. W. Morrs and Co., Inc.  is among the 
Description: 
many health topics to be addressed. The researh is funded jointly by ODPHP, OSAP, CDC, 
and the Deparents of Transporttion and Education. The fIrst step, a literatue review on 
high risk youthigh risk behavior, has been completed The next component involves the 
planning and completion of an extensive qualitative researh effort which wil include at least 
20 focus grup sessions with youth frm the taget population. The final product wil be a set 
of materials that can be effectively used to disseminate and promote the results of the research 
to a wide audience of intermediares and practitioners who can then use the results as an aid or 
guide in planning and developing health communications to this target audience. 
ODPHP, OASH, 330 C Street SW, Washington, DC, 20201 
Contact:  TREATMENT AND CARE FOR YOUTH INFECTED WITH HIV 
AIDS Clinical Trils Group 
NI 
conducts and supports intramural and extramur research aimed at 
Description: 
developing safe and effective therapies for HIY inection and associate opportunistic 
inections and cancers. There ar no trals designed specifcaly for adolescents, but anyone 
over 12 is generaly eligible for the adult trals. Adolescents under 18 are also usualy eligible 
priary 
for pedatrc traNls, bIu t these are  focused on infants and young children. As 
Januar 1990,  supported 32 adult AIDS Cliical Trials Units (Acrs), some of which 
also were sponsorig  pedatrc patients. In adtion, NIAID supportd
several trals for 
Acrs 
designed specificaly for children. The 28 pedatrc centers of NICHD ar now 
collaboratig with the AIDS Clinical Trials Group. 
, NI
Division of AIS, NIAID , 603 Executive Boulevard, Rockvile, MD, 20895
Contact: 
Community Programs for Clinical Research on AIDS 
Ths initiative expands NIID' s clinical investigations by including primar care 
Description: 
physicians who ar not afliated with AIDS research effort cUlently supported by NIAID. 
The progr places importce on increasing the patient population base for AIDS clinical 
researh by including more HI-inected black and Hispanic persons and IV drg users, and 
HI 
more women at risk of  infection. The researh settings and methods are expected to 
differ from those of trditional clinical researh. The community programs operate separately 
from, but work closely with, the existing AIDS Clinical Trials Units and 
wil not replicate 
strctu, 
their  functions, or research. The CPCRA sites are makng specific attempts to reach 
poor and minority populations, including youth. Anyone over 12 wil be able to enroll. 
Community Clinical Research Section, Division of AIDS, NIAID, NIH, 6003 
Contact: 
Executive Boulevard, Rockvile, MD, 20895 
Pediatrc AIDS Health Care Service Demonstration Projects 
Description:  These projects ar expected to: demonstrte effective ways to prevent infection 
especially though reuction of perinata transmission; develop community-based, 
famly-centered coordiated services for infecte infants and childrn; and develop progrs 
to reduce the spread of infection to vulnerable populations of young people. In addition, a 
number of projects provide appropriate developmenta services to deal with neurological 
deficits and developmenta disabilties found in HIY-infected childrn. Seventeen Pediatrc 
projects were funded in Fiscal Year 1989. Severa of these demonstrtions include 
adolescents. They ar located in Puert Rico, Georgia, Washington State, Texas, New York 
California, and Louisiana. 
Division of Services for Childrn with Special Car Needs, MCHB, HRSA, 5600 
Contact: 
Fishers Lane, Rockvile, MD, 20857.  AIDS Service Demonstration Projects 
AIS 
Although the  Servce Demonstrtion Projects focus on adults, some 
Description: 
projects have diecte this money toward adolescents. For instace, in New York City, the 
funds pay for a coordnator of AIDS prevention at the Covenant House shelter. Funds also go 
Mar 
to the Hetrck  Institute, which specials in services for gay adolescents, and to the LA 
AIS/H 
Youth  Prvention Prject. 
HI 
Division of  Servces, BHR, HRSA, 560 Fishers Lane, Rockvile, MD, 20857.
Contact: 
Developmental Disabilities and HIV: Training 
for Services and Policies 
The focus of ths project, ru by the Chidrn s Hospita University Affliated 
Description: 
Prject in Boston, is on the effectiveness of service delivery to infants with congenita HIY 
chidrn with acquir infection, youth and young adults at risk, infected 
inection, older 
adults with menta retadation, and primar car providers. Resource and traiing materials 
will be provided on famly support issues, external aras affecting service delivery, income 
and liabilty, and models of service delivery. 
Admnistrtion on Developmental Disabilties, OHDS, 200 Independence Avenue 
Contact: 
, Washigton, DC, 20201 
Servng HIV Infected Children, Youth and Their Families: A Guide for Residential 
Group Care Providers 
Ths monogrph, developed under a consultat agrement with the Child Welfare 
Description: 
League of America, describes problematic policy issues for residential facilities for 
adolescents, includig in-patient psychiatrc treatment centers and runaway shelters. Subjects 
include liabilty, health stadads, confidentiality, and testing. 
Child and Famly Support Brach, Division of Education and Service Systems 
Contact:  , Nl
Liaison , ADAMH, 5600 Fishers Lae, Rockvile, MD, 20857 
BASIC NEEDS AND SERVICE INTEGRATION 
Homeless Youth Monograph 
This monogrph wil describe six programs which have been identied as 
Description: 
exemplifying goo practice in providig services to homeless youth who ar emotionally 
HI 
trubled, substace abusing and at high risk for  infection. The monogrph wil be 
published in the Fal of 1990.  Famy Support Brach, Division of Education and Service Systems 
Contact:  Child and 
Liaison, NIM, ADAMH, 5600 Fishers Lae, Rockvile, MD, 20857 
Comprehensive Servce Research for Homeless Adolescents Who Have, or are at 
Riskfor, Severe Emotional Disturbance 
NI 
grt 
Under ths new research announcement,  wil provide  support to 
Description: 
study the service nees of homeless adolescents and to demonstrate and evaluate the 
effectiveness of varous approaches to organzing and providing a system of care for homeless 
adolescents. HI-infected homeless youth are identied as a specific group about whom little 
else is known and who ar an importt taget population for this announcement. 
Child and Famly Support Brach, Division of Education and Service Systems 
Contact:  NI, 
ADAM, 
Liaison  5600 Fishers Lae, Rockvile, MD, 20857 
Cooperative Agreements for Research Demonstration Projects on Alcohol and Other 
Drug Abuse Treatment for Homeless Persons 
The genera purose of this new research demonstration program is to contrbute 
Description: 
to scientic knowledge regarding effective interventions for homeless individuals with 
alcohol and/or other drg problems. Hypotheses should be tested in terms of the following
priar 
objectives: reuction of the consumption of alcohol and/or other drgs; increase 
levels of shelter and residential stabilty; and enhancement of the economic and/or 
employment status of the taget population. Other objectives that may be addressed include: 
improvement in the health and menta health status of the taget population; and increased 
cooperation and linkages among service agencies in addressing the multiple needs of 
homeless individuals with alcohol and/or other drg problems. Applications addssing the 
special nees of varous homeless populations, includig adolescents and young adult males, 
were encouraged. A number of applications have been received and ar now in the review 
process. 
Homeless Demonstration and Evaluation Brach, Division of Clinical and 
Contact: 
Prvention Researh, NIAAA, ADAMH, 560 Fishers Lane, Rockvile, MD, 20857. 
Co-sponsored by NIDA.  SERVICES 
HIV COUNSELING AND TESTING 
Counseling, Testing, Referral, and Parter Notification (CTRPN) 
CfN 
provides importt information which can promote safer behavior in 
Description:  HI 
individuals who either ar infected with  or engage in activities that place them at risk of 
CfN 
beoming inected The goals of  are: (1) to provide individuals with knowledge of 
HI 
their curent  status; (2) to refer persons who are inected to a medical provider capable of 
providig follow-up car and medcal management ofHI-related ilnesses; (3) to provide 
education to help to initiate behavior change and reuce risky behavior; (4) to prevent the 
HI  HI 
spread of  infection by providig  infected persons with information regardig 
behaviors essential to avoid the trsmission of the virs to others; (5) to provide information 
identified sex and neee-sharng parers; (6) to encourage sex and 
testig, and counseling to 
HI 
needle-sharng parers to avoid any futue behavior that might result in  infection; (7) to 
provide informtion about benefits of medical evaluation and treatment for infected 
individuals with low CD4 cell counts, and (8) to identiy sex/needle-sharng parers who 
HI  tang 
need to be aware of their risk of  infection. The extent to which stret youth are 
CfN 
advantage of available  services is unclear. 
CPS, CDC, Atlanta, GA, 30333 
Contact: 
HIVIAIDS Prevention and Treatment Program for Community Health Centers 
Under an interagency agrment between the CDC and BHCDA in June 1989,
Dteschription : 
demonstrtion sites received supplementa awards of $500,000 per site to parcipate in a 
comprehensive HI/AIDS prevention and tratment program. The thee parcipatig 
Community Health Centers are located in the Bronx, Miam, and Newark. HIY testing wil be 
one of the added services. The Newark CHC wil be opening a site tageting high risk youth 
drg 
near a high school which wil be able to refer students for STDs,  counseling, and other 
health problems. 
Progr 
Division of Special Populations  Development, BHCDA, HRSA, 5600 
Contact: 
Fishers Lane, Rockvile, Iv, 20857  BEHAVIORAL AND EDUCATIONAL INTERVENTIONS

Drug Abuse Prevention Program/or Runaway Youth 
progr 
The purose of this  is to provide improved and expanded drg abuse 
Description: 
prevention and reduction services to ruaway and homeless youth. In Fiscal Year 1989, 103 
projects were funde. 
Famy and Youth Servces Bureau, ACYF, OHDS, 200 Independence Avenue SW, 
Contact: 
Washigton, DC 20201 
Drug Abuse Treatment Demonstration Program 
Integrated Primary Health Care 

progr  NIA grts 
A joint  between BHCDA and  money to 21 organzations 
Description:  Th 
HI 
for drg treatment for those at high risk of  infection.  of these organizations taget 
adolescents: 1) The University of Texas Health Science Center wil establish a comprehensive 
project at the Juvenile Detention Center of Bexar County; 2) the Health Division of 
Multnomah County, OR has a specifc goal of tageting street youth and other subpopulations; 
3) the Children  drgusers aged 12-24. 
s Hospita in Los Angeles works with 
Progr 
Division of Special Populations  Development, BHCDA, HRSA, 5600 
Contact: 
Fishers Lane, Rockvile, MD, 20857 
AIDS Prevention Services by Health Providers/or Homeless, Runaway, and Non-
School Youth

Description:  This project wil develop a new videotape for youth and a new curculum for 
adult providers. The contractor is ODN Pructions in New York City. This is one of six 
projects funded under the National Issues of High Prority in Pediatrc AIDS program. 
Division of Services for Childrn with Special Car Needs, MCHB, HRSA, 5600 
Contact: 
Fishers Lane, Rockvile, MD, 20857 
Minority AIDS Education/Prevention Grant Program 
progr 
This  was created to demonstrate the effectiveness of education and 
Description: 
prevention strtegies tagetig raial and ethnic miorities which: 1) expand the rage of 
HI 
community-based and national organizations involved in  infection/AIDS education and 
prevention activities, and 2) encourage innovative approaches that appropriately address the 
diversity within and among minority populations. At least 16 of the 38 
grts awarded 
Fiscal Year 1988 or 1989 went toward youth-oriente activities, and at least 4 of these targeted 
street youth specifically. 
OMH, OASH, 200 Independence Avenue SW, Washington, DC, 20201
Contact:  AIDS High Risk Adolescent Prevention Program 
This trning progr is dited to youth services workers who come into 
Description: 
contact with high risk adolescents. These workers include adctions counselors; foster care 
workers; juvenile probation offcers; youth and famy services counselors; street outreach 
workers; reeation specialsts; and sta of runaway shelters, SID clinics, and teen pregnancy 
progrs; and health personnel therapists who work with adolescents. 
ADAM, 
Community Researh Branch, Division of Applied Research, NIDA 
Contact: 
560 Fishers Lae, Rockvile, MD, 20857 
Health Education/Risk Reduction (HE/RR) 
progrs 
The focus of HEIRR  is to prevent, reuce, or elimiate high risk 
Description: 
behaviors and enlist support for prevention activities among: (1) individuals whose behavior 
may place them at incrased risk of infection; (2) infected individuals and their sex and 
neede-sharng parers; (3) racial and ethnic minority populations; (4) women of childbearg 
age who are at risk; (5) health-car providers; and (6) other groups whose activities or 
HE 
HI. 
behaviors may place them at risk of  activities include group counseling of 
seropositive individuals and street outrach program that reach intrvenous drg users, male 
and female prostitutes, runaway and homeless youth, and other high-risk persons not in 
tratment or not receivig social servces. HEIR projects may be conducted in correctional 
runaway and homeless youth, housing projects, community health 
facilties, shelters for 
centers, mobile vans, and churches. 
CPS, CDC, Atlanta, GA, 30333 
Contact: 
Minority Initiatives 
HI/AIS 
Par of the  prevention funds awarded to State and local health 
Description: 
HI 
deparents is used solely for special initiatives providing  prevention services to racial or 
priar 
ethnic minorities. In Fiscal Year 1989, 281 organizations whose  focus is minority 
populations were funded. Twenty-two percent of these organizations worked with youth. 
CPS, CDC, Atlanta, GA, 30333 
Contact: 
Direct Funding of Minority and Other Community-Based Organizations 
In addition to the prevention cooperative agreements awarded to State and local 
Description: 
health agencies, CDC dictly provides funds and tehnical assistace to minority and other 
community-based organizations (CBOs) in the metropolita statistical areas most heavily 
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afected by  infection and AIDS. Forty-four of the 68 CBOs funded in Fiscal Year 1989 
worked with youth. Interventions include street outrach, general education, peer education 
social service agency and drg treatment based education, condom distrbution and safe sex 
education, theater, prevention oriented follow-up and behavior reinforcement of HIY positive  persons and their famlies, and programs designed to encourage people to receive 
counseling, testig, and follow-up.

CPS, CDC, Atlanta, GA, 30333
Contact: 
United States Conference of Mayors HIVIAIDS Education Grants Program 
With the help of a cooperative agreement with CDC, the United States 
Description: 
Conference of Mayors has been giving fiancial and tehnical assistace to community-based 
organizations since 1985. Severa of the funded projects taget youth. 
Office of the Deputy Dirctor for HI, CPS, CDC, Atlanta, GA, 30333
Contact: 
School Health Education Program 
The Division of Adolescent and School Health (DASH), within CCDPHP, funds 
Description: 
and 16 local education agencies largely to provide prevention programs for youth 
al State 
who attend school. Each funded State and local education agency also conducts activities to 
assist agencies that provide HIY education for high-risk, out-of-school, and minority youth, 
Progr 
and for youth who have special education needs.  activities for out-of-school youth 
var among State or local education agencies, but often include trning community agency 
providers, includig staf at runaway shelters, alternative education centers, and corrctional 
facilties. 
DASH, CCDPHP, CDC, Atlanta, GA, 30333.
Contact: 
Note: The DASH also fund six national organizatins Jor work with out-oj-school youth. The 
Jollowing six listings describe these organizations' activities. 
Center for Population Options (CPO) 
The Center for Population Options provides technical assistance and training to 
Description:  HI 
national youth-serving, youth employment, and education organizations on  education 
policy, progr, and peer program development. Organizations which receive intensive 
technical assistace and trning include: Big BrotherslBig Sisters, YWCA, Salvation Ary, 
Girls Clubs of America, and the National Urban League. CPO also sponsors an annual 
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national conference on  and Adolescents, and prouces a varety of publications related to 
HI 
adolescent HIY education, includig a life planning curculum, a series of  and 
Out oj the Shaws: Building an Agend and Strategies for 
adolescent fact sheets, and 

Preventing HN Injection and AIDS Among Street and Homeless Youth. 
DASH, CCDPHP, CDC, Atlanta, GA, 30333
Contact:  National Coalition of Advocates for Students (NCAS) 
HI 
This national organization provides support for  education in both schools 
Description: 
settgs for school-aged youth. NCAS has tageted education activities for 
and non-trditional 
migrt farworker youth in Florida Texas, Mississippi, Nort Carolina, and Washington. 
HI  migrt 
NCAS also provides  prevention education to  health organizations and clinics, 
and assistace in developing or identifying educational materials sensitive to ethnic minority 
youth, includig materials in Spanish and Haitian Crole. NCAS is developing an 
curculum for Latio 
migrant youth. 
DASH, CCDPHP, CDC, Atlanta GA, 30333
Contact: 
National Coalition of Hispanic Health and Human Services Organizations 
(COSSMHO) 
The objective of this cooperative agreement is to mobilze community-based 
Description:  HI 
organizations to provide  prevention education tageting out-of-school Hispanic youth. 
COSSMHO has conducted workshops in New York City, EI Paso, Los Angeles, Chicago, and 
HI 
San Juan to help community organizations with  education needs, innovative strategies to 
reach Hispanic youth, and resource identification. 
DASH, CCDPHP, CDC, Atlanta GA, 30333
Contact: 
National Commission on Correctional Health Care (NCCHC) 
Description:  The National Commssion on COITectional Health Car serves incarcerated youth 
my 
nationwide. It has conducted an  educational needs 
in detention and cOITectional facilties 
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assessment in more than 1300 facilties serving youth, and provides  education traiing 
sessions for cOITectional facilty providers serving youth. NCCHC wil also conduct a youth 
knowledge, attitudes, and behavior surey. 
DASH, CCDPHP, CDC, Atlanta, GA, 30333
Contact: 
National Network of Runaway and Youth Services (NNRYS) 
The National Network of Runaway and Youth Services provides support for 
Description: 
organizations serving the need of homeless and runaway youth. NNRYS has sureyed 
national network members to determe the availabilty of my education, and the specific 
nees of runaway and homeless programs. In response to needs identified in the surey, 
HI 
NNRYS developed an  education curculum  for high risk
entitled  Safe Choices 

out-of-school youth. Modules in the curculum are designed for use in street outrach 
progrs, 
shelters, telephone hotlines, detention centers, and group homes. 
DASH, CCDPHP, CDC, Atlanta, GA, 30333
Contact:  National Organization of Black County Officials (NOBCO) 
The objective of this cooperative agreement is to increase the avaiabilty of 
Description: 
rual 
prevention education to Black and other ethnic minority youth residing in urban and 
acss 
communities  the United States. NOBCO has developed and pilot-tested a model 
prevention program which wil be available for national dissemination in the 1989-90 program 
HI  progr 
year. The  prevention  is adptable and suitable for use in school and 
furer 
out-of-school settgs. Other activities include national workshops designed to 
educate NOBCO members and afilates about the nee for my prevention education at the 
local level.

DASH, CCDPHP, CDC, Atlanta, GA, 30333
Contact: 
TREATMENT AND CARE FOR YOUTH INFECTED WITH HIV 
The Federa government generaly does not provide or fund health care services diectly. 
However, there are a few programs sponsored by HRSA though which mY-positive street 
youth may have access to care. The BHCDA funds Community and Migrant Health Centers 
and Health Car for the Homeless projects across the countr. Also, as mentioned above, the 
MCHB and BHR admnister the Pediatrc AIDS Demonstration Projects and the AIDS 
Service Demonstration Prjects. In addtion, some street youth may be eligible for Medicaid, 
which reimburses health car providers for servces rendered. 
BASIC NEEDS AND SERVICE INTEGRATION 
Runaway and Homeless Youth Program 
progr 
The purose of this  is to provide fmancial assistance to establish or 
Description: 
strengthen community-based centers that adess the imediate needs (e.g. outreach 
tempora shelter, counseling, and aftercar servces) of runaway and homeless youth and 
their famies. The program goals and objectives of the Runaway and Homeless Youth Act are 
to assist runaway and homeless youth centers to: 1) alleviate the problems of runaway and 
homeless youth, 2) reunite youth with their famlies and encourage the resolution of 
intrafamly problems though counseling and other services, 3) strengthen famly relationships 
and encourge stable living conditions for youth, and 4) help youth decide upon constrctive 
courses of action. 
Famly and Youth Services Bureau, ACYF, OHDS, 200 Independence Avenue SW 
Contact: 
Washington, DC 20201  Homeless Youth
Transitional Living  Program for 

progr 
The purose of this  is to provide technical and financial assistace to 
Description: 
organizations that wil provide comprehensive services and shelter to homeless youth ages 16 
progr 
thugh 21 for up to 18 months. The goals of the  are to promote a transition to 
dependency on social services. 
self-sufciency and to prevent long-term 
Famly and Youth Services Bureau, ACYF, OHDS, 200 Independence Avenue SW, 
Contact: 
Washington, DC 20201 
State Networking on AIDS and Out-of-Home Adolescents 
This project involved technical assistace and consultation services to seven 
Description: 
States and the Distrct of Columbia. The fIrst phase of the project consisted of a meeting of 
State delegations (child menta health, health, social services, and an alternative provider) to 
focus on the design of services for seropositive and symptomatic youth who are in the care of 
the State or who ar on their own (e.g., homeless). The meeting provided technical assistace 
to States to develop comprehensive plans for these high risk adolescents. Following the 
meetig, consultation funds were made avaiable to four of these States to follow up on the 
planing which occured at the meeting. 
Child and Famy Support Brach, NIMH, ADAMH, 5600 Fishers Lane,
Contact: 
, 20857
Rockvile,  NETWORKING 
EXTERNAL WORKSHOPS AND CONFERENCES 
The Deparent has sponsored severa national and regional conferences focusing in whole or 
HI 
in par on  and street youth. Summar information on a selection of these conferences 
follows. 
Surgeon General' s Workshop on Children with HIV Infection and Their Families 
Scope: National

Site: Philadlphia, PA 
Date: Apri 1987

Departental sponsor: BMCH 
AIDS and Adolescents: Exploring the Challenge 
Scope: National 
Site: New York, NY 
Date: Marh 1988 
Departental sponsors: NIDA, NIMH, BMCHR, NICHD 
Knowledge Development Workshop: Issues in the Prevention and Treatment of 
AIDS Among Adolescents With Serious Emotional Disturbance 
Scope: National 
Site: Washington, DC 
Date: June 1988

Deparbnental sponsor: 

Adolescents with AIDS: Consortium Buildingfor High Risk Youth Through Coor
dination of Prevention, Services and Research 
Scope: Regional 
Sites: Washington, DC; Chicago, IL; Miam, FL; New York, NY; San Francisco, CA; 
Houston, TX 
Date: Thoughout 1989 
Departmental sponsors: NIDA, NIMH, BMCHR, NICHD  Human Immunodeficiency Virus (HlV) in Adolescents: Settng a National Research 
Agenda for the 1990' 
llS 
Scope: National (primarly for  employees) 
Site: Bethesda, MD 
Date: Januar 1989 
Deparbnental sponsor: 

Fifth Annual National Pediatrc AIDS  Sur
Conference and Follow-up to the  1987
geon General' s Workshop on Children with HlV Infection and Their Families 
Scope: National 
Site: Los Angeles, CA 
Date: September 1989

BMCH 
Deparbnental sponsor: 
HIV Prevention Strategies for Runaway and Homeless Youth 
Scope: Bi-regional (HS Regions IX and X) 
Site: San Francisco, CA 
Date: October 1989

Deparbnental sponsor: PHS Regional Offces, NAPO 
New England Conference on AIDS and Youth: Strategies for Prevention 
Scope: Regional 
Site: Boston, MA 
Date: November 1989 
Departmental sponsor: BHP 
West Coast Scientific Symposium on Homeless and Runaway Youth 
Scope: Regional 
Site: San Francisco, CA 
Date: Mach 1990 
BMCH 
Departmental sponsor: 
International Conference on Homeless Youth and AIDS 
Scope: International 
Site: San Francisco, CA 
Date: June 1990

Departmental sponsors: NIM, NICi  Adolescents and HIV/AIDS 
Scope: Regional 
Site: Peekskill, NY 
Date: June 1990

Departmental sponsor: BHP 
INTERNAL COMMISSIONS AND TASK FORCES 
The Presidential Commission on the Human Immunodeficiency Virus Epidemic issued its 
fInal report in June 1988. It contaned approximately 600 recommendations, many of them 
releva,t to strt youth. The National Commission on Acquired Immune Deficiency 
Syndrome has thus far released thee short reports, one of which made a specific reference to 
street youth at risk of infection. 
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The National AIDS Program Offce organzes  separte bodes which meet regularly to 
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coordiate the Federa response to the  epidemic. They ar: 
1. HIV Leadership Group. Its members include the Assistat Secretar for Health (Chair); 
Dirctor of NAP (Co-Chai); Surgeon General; Agency Heads of AHCPR, ADAMH, 
CDC, FDA, HRSA, NI, and ilS; AIDS Coordinators of AHCPR, ADAMH, CDC, 
FDA, HRSA  NI, and ilS; Deputy Assistat Secretaes for Health, HealthScience and 
Envionment, Health Communications, Health Operations, Health (Disease Prevention 
and Health 
and Health Promotion), Health (planning and Evaluation), Population Affais, 
(Intergovernmental Affai); and additional OASH Staf from NAPO, OMH, Office of 
Health Legislation, Executive Secretaat, and Offce ()f General Counsel. Other PHS 
staf ar invited to attend when appropriate. 
2. PHS Executive Task Force on AIDS. This group has 47 members including repre
sentatives from NAPO, Offce of Surgeon General, ADAMH, AHCPR, ASPE, CDC, 
NI,  Ca 
HRSA, ilS,  the Health  Financing Admnistrtion, the Social Securty Ad
ministration, and offces within OASH. 
The Executive Task Force maitans several panels focusing on specific issues, .one of 
which is the Panel on Women, Adolescents, and Children with HIV Infection and 
chai 
AIDS. This Panel is  by the Surgeon Genera, co-chaied by the Director of 
NAPO, and includes representatives of AHCPR, ADAMH, CDC, FDA, HRSA, ilS, 
NIH, OASH, OffIce of the Secretar (Offce of International Health), and Deparent of 
Defense. 
3. PHS Federal Coordinating Committee on the HIV Epidemic. This group draws from 
outside HIS, and apar from its chai (the Director of NAPO) has no official HIS mem
bers. The Cabinet Deparents represented are Agrcultue, Defense, Energy, Education 
Housing and Urban Development, Justice, Labor, State, Trasporttion, and Yeterans Af Securty Agency, ACTION, En
fais. Other agencies represented include the National 

vironmenta Protection Agency, Federa Emergency Management Agency, General Ser
vices Admistration, U.S. Informtion Agency, National Aeronautics and Space 
Admnistration, Agency for International Development, Merit Systems Protection Board, 
Peace Corps, Offce of Personnel Management, Office of Management and Budget, and 
the President s Domestic Policy Council. When appropriate, PHS staff ar invited to at
tend the meetigs.