HIV INFECTION AMONG STREET YOUTH


DEPARTMENT OF HEALTH AND HUMAN SERVICES

PROGRAMS AND RESOURCES


'''VJCIS. lJd' . t 

OFFICE OF INSPECTOR GENERAL 

OFFICE OF EVALUATION AND INSPECTIONS 

SEPTEMBER 1990 
HIV INFECTION AMONG STREET YOUTH


DEPARTMENT OF HEALTH AND HUMAN SERVICES

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 

the problem is compounded by researh gaps and by strctu barers at the local and Federal 

levels. It recommende that the Public Health Service conduct additional research on the 

causes and results of HI infection among street youth. It also recommended that the Office 

of Human Development Servces, in concert with the Public Health Service, implement a plan 

to curb the spread of HI among street youth in five cities with large concentrations of street 

youth and high rates of HI 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 

these broady tageted progrs 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. 

The listigs are divided into th categories: research, services, and networking. The fIrst 

section descrbes activities whose primar purose is to answer specific questions over a finite 

time period. The second section describes activities whose priar purpose is to give 

fmancial support to organizations involved in the dict provision of services. The third 

section describes activities designed to foster communication and coordiation between 

people involved in fightig HI 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 

ADAM 

AHCPR 

AIS 

ASPE 

BHCDA 

BHP 

BHR 

BMCH 

Admnistrtion for Childrn, Youth, and Famlies 

Alcohol, Drg Abuse, and Menta Health Admnistrtion 

Agency for Health Car Policy and Research 

Acquired Immunodeficiency Syndrome 

Assistat Secta for Planning and Evaluation 

Burau of Health Car Delivery and Assistace 

Burau of Health Professions 

Burau of Health Resources Development 

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 

CDC 

CID 

CPS 

DASH 

HHS 

HRSA 

IHS 

MCHB 

NAPO NIA


NIID 

NICH 

NIDA 

NIH 

NIMH 

OASH 

ODPHP 

OHDS 

OMH 

OSAP 

PHS 

SSA 

SID 

Center for Chronic Disease Prevention and Health Promotion 

Centers for Disease Control 

Center for Infectious Diseases 

Center for Prvention Services 

Division of Adolescent and School Health 

Deparent of Health and Human Services 

Human Imunodeficiency VlIS


Health Resources and Services Admnistrtion 

Indian Health Service 

Intrvenous 

Maternal and Child Health Bureau 

National AIS Program Offce 

National Institute on Alcohol Abuse and Alcoholism 

National Institute of Allergy and Infectious Diseases 

National Institute of Child Health and Human Development 

National Institute on Drg Abuse 

National Institutes of Health 

National Institute of Menta Health 

Office of Assistat Secreta for Health 

Office of Disease Prevention and Health Promotion 

Office of Human Development Services 

Office of Minority Health 

Office of Substace Abuse Prvention 

Public Health Service 

Social Securty Admnistrtion 

Sexually Trasmitted Disease 
RESEARCH


SEROPREVALENCE, EPIDEMIOLOGY, AND AIDS CASE SURVEILLANCE 

HIV Seroprevalence Surveys 

Description: These sureys ar designed to determne the rate of HI 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 

homeless youth. These sureys ar anonymous and blide the only information attached to 

test specimens is age grup, sex, race, and pricipal HI risks (if known). The CDC hopes to 

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. 

Contact: Seroepidemiology Branch, Division ofHIY/AIDS, CID, CDC, Atlanta, GA, 30333.

Heterosexual Transmission of HIV and Related Retroviruses 

Description: Nll is funding prospective studies of 2 000 people in Newark and Brooklyn. 

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 

cofactors associated with HI 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. 

Contact: Epidemiology Brach, Division of AIS, NIID, Nll, 6300 Executive Boulevard, 

Rockville, , 20895 

San Francisco Men s Health Study 

Description: This study has the same genera goal as the heterosexual transmission studies 

describe above. Gay adolescents and young mae prostitutes wil be included. 

Contact: Epidemiology Brach, Division of AIDS, NIAID, Nll, 6300 Executive Boulevard

Rockvile, , 20895 

National AIDS Case Surveillance 

Description: All states have regulations requirng health care providers to report all AIDS 

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. 

Contact: Sureilance Brach, Division ofHIY/AIDS, CID, CDC, Atlanta, GA, 30333. 
BEHAVIORAL AND EDUCATIONAL RESEARCH 

AIDS Prevention for High Risk Adolescents 

Conducted by the HI Center for Clinical and Behavioral Studies, the goal of 

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 

Description: 

effort between New York Psychiatrc Institute and four community agencies. The intervention 

model imrses youth in 10 session programs to decrase unsafe behaviors. The intervention 

focuses on increasing general knowledge about AIDS and transmission of HI 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 care. Parcipating agencies as well as researchers from the Institute 

have formed a work group to maimize the effectiveness of the intervention in each setting 

and with each population. 

Offce of AIDS Progr, NI, ADAMH, 5600 Fishers Lane, Rockvile, MD, 

20857 

Contact: 

HIV in Street Youth: Epidemiology and Prevention 

This study, conducte by the Deparent of International Health at Johns 

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. 

Description: 

Health and Behavior Researh Branch, Division of Basic Bran and Behavioral 

Sciences, Basic Prvention and Behavioral Medcine Research Branch, NIMH, ADAMH, 

5600 Fishers Lane, Rockvile, MD' 20857 

Contact: 

Cooperative Agreementfor Multi-Site Trils of Behavioral Strategies to Prevent the 

Further Spread of HIV Infection 

Description: NI issued a request for applications in Spring 1990, to conduct a 

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 

effort; 2) assess existing intervention efforts and improve the existing educational and mass 

media strategies that have shown some effectiveness; and 3) develop an overall effective 

intervention progr to promote behavior change that wil prevent the further spread of the 

HIYepidemic. Emphasis wil be placed on the development and testing of preventive 
20857 

interventions in groups at high risk for HI infection, including homeless and runaway 

adolescents. 

Contact: Office of AIDS Progr, NIM, ADAMH, 5600 Fishers Lane, Rockvile, l\ 

Public Knowledge, Atttudes, and Behavior Concerning AIDS 

An AIDS Extrural Research Grt to the University of Calfornia at Davis

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. 

Description: 

Contact: Division of Basic Brai and Behaviora Sciences, NIM, ADAMH, 5600 Fishers 

Lane, Rockvile, l\, 20857 

National AIDS Demonstration Research Grants and AIDS Targeted Outreach 

Model Contracts 

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 

after intervention using the AIS 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 

Data Coordnation and Evaluation Center program a contrtor collects HI antibody status 

data frm the National AIDS Demonstration Researh grantees. 

Description: 

Community Researh Branch, Division of Applied Research, NIDA, ADAMH 

5600 Fishers Lae, Rockvile, MD, 20857 

Contact: 

WARN and Abt, Inc. 

These contrctors are evaluating outrach and intervention strategies focused on 

two groups of women at risk for HI, 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. 

Description: 

Community Researh Branch, Division of Applied Research, NIDA, ADAMH 

5600 Fishers Lane, Rockvile, MD, 20857 

Contact: 
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 

with these youth; and providing a centrze 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 

5600 Fishers Lae, Rockvile, MD, 20857 

Contact: 

Circle 

Description: This contrctor is operatig in Washington, DC, testing the effects of an

education and outreach progr for juvenile offenders and high risk youth. Over 

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. 

HI/AIS 

Contact: Community Researh Branch, Division of Applied Research, NIDA, ADAMH 

5600 Fishers Lae, Rockvile, MD, 20857 

AIDS Community Outreach Demonstration Project 

Description: Run by the University of Texas Health Science Center in San Antonio, this 

project wil implement and evaluate an AIDS education and counseling program The target 

populations are drg abusers, their mates, prostitutes, and runaways. The subjects wil be 

randomly assigned to stada or intensive counseling and outcomes wil be compard. 

Community Research Branch, Division of Applied Research, NIDA, ADAMH 

560 Fishers Lae, Rockvile, MD, 20857 

Contact: 
AIDS Outreach to IV Drug Users, Sex Partners and Runaways 

Description: Ths project is being conducted by the Psychology Deparent at California 

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 

560 Fishers Lae, Rockvile, MD, 20857 

Contact: 

HIV Community Demonstration Projects 

Description: These seven projects ar flexible, community-based research efforts for the 

development, implementation, and evaluation of interventions to decrease the probabilty of

HI transmission in a community. The progrs began on a small scale in FY 1985, and 

initially dited 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 

groups; prostitutes; and high-risk youth, such as runaways. These projects are curently 

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. 

Contact: CPS, CDC, Atlanta, GA, 30333. 

Evaluating Effective Communication Strategies for Health Information to High Risk Youth Outside of School 

Description: This is a two year contract with S. W. Morrs and Co., Inc. HI is among the 

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. 

Contact: ODPHP, OASH, 330 C Street SW, Washington, DC, 20201 
TREATMENT AND CARE FOR YOUTH INFECTED WITH HIV 

AIDS Clinical Trils Group 

Description: NI conducts and supports intramural and extramur research aimed at 

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 

for pedatrc trals, but these are priary focused on infants and young children. As 

Januar 1990, NI supported 32 adult AIDS Cliical Trials Units (Acrs), some of which 

also were sponsorig several trals for pedatrc patients. In adtion, NIAID supportd

Acrs designed specificaly for children. The 28 pedatrc centers of NICHD ar now 

collaboratig with the AIDS Clinical Trials Group. 

Contact: Division of AIS, NIAID, NI, 603 Executive Boulevard, Rockvile, MD, 20895

Community Programs for Clinical Research on AIDS 

Description: Ths initiative expands NIID' s clinical investigations by including primar care 

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 

more women at risk of HI 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 

their strctu, 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. 

Contact: Community Clinical Research Section, Division of AIDS, NIAID, NIH, 6003 

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. 

Contact: Division of Services for Childrn with Special Car Needs, MCHB, HRSA, 5600 

Fishers Lane, Rockvile, MD, 20857. 
AIDS Service Demonstration Projects 

Although the AIS Servce Demonstrtion Projects focus on adults, some 

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 

to the Hetrck Mar Institute, which specials in services for gay adolescents, and to the LA 

Youth AIS/H Prvention Prject. 

Description: 

Contact: Division of HI Servces, BHR, HRSA, 560 Fishers Lane, Rockvile, MD, 20857.

Developmental Disabilities and HIV: Training for Services and Policies 

The focus of ths project, ru by the Chidrn s Hospita University Affliated 

Prject in Boston, is on the effectiveness of service delivery to infants with congenita HIY 

inection, older chidrn with acquir infection, youth and young adults at risk, infected 

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. 

Description: 

Admnistrtion on Developmental Disabilties, OHDS, 200 Independence Avenue 

, Washigton, DC, 20201 

Contact: 

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 

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. 

Description: 

Child and Famly Support Brach, Division of Education and Service Systems 

Liaison, Nl, ADAMH, 5600 Fishers Lae, Rockvile, MD, 20857 

Contact: 

BASIC NEEDS AND SERVICE INTEGRATION 

Homeless Youth Monograph 

Description: This monogrph wil describe six programs which have been identied as 

exemplifying goo practice in providig services to homeless youth who ar emotionally 

trubled, substace abusing and at high risk for HI infection. The monogrph wil be 

published in the Fal of 1990. 
Child and Famy Support Brach, Division of Education and Service Systems 

Liaison, NIM, ADAMH, 5600 Fishers Lae, Rockvile, MD, 20857 

Contact: 

Comprehensive Servce Research for Homeless Adolescents Who Have, or are at 

Riskfor, Severe Emotional Disturbance 

Description: Under ths new research announcement, NI wil provide grt support to 

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 

Liaison NI, ADAM, 5600 Fishers Lae, Rockvile, MD, 20857 

Contact: 

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 

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. 

Description: 

Homeless Demonstration and Evaluation Brach, Division of Clinical and 

Prvention Researh, NIAAA, ADAMH, 560 Fishers Lane, Rockvile, MD, 20857. 

Co-sponsored by NIDA. 

Contact: 
SERVICES 

HIV COUNSELING AND TESTING 

Counseling, Testing, Referral, and Parter Notification (CTRPN) 

CfN provides importt information which can promote safer behavior in 

individuals who either ar infected with HI or engage in activities that place them at risk of 

beoming inected The goals of CfN are: (1) to provide individuals with knowledge of 

their curent HI 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 

spread of HI infection by providig HI infected persons with information regardig 

behaviors essential to avoid the trsmission of the virs to others; (5) to provide information 

testig, and counseling to identified sex and neee-sharng parers; (6) to encourage sex and 

needle-sharng parers to avoid any futue behavior that might result in HI 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 

need to be aware of their risk of HI infection. The extent to which stret youth are tang 

advantage of available CfN services is unclear. 

Description: 

Contact: CPS, CDC, Atlanta, GA, 30333 

HIVIAIDS Prevention and Treatment Program for Community Health Centers 

Under an interagency agrment between the CDC and BHCDA in June 1989, th 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 

near a high school which wil be able to refer students for STDs, drg counseling, and other 

Description: 

health problems. 

Division of Special Populations Progr Development, BHCDA, HRSA, 5600 

Fishers Lane, Rockvile, Iv, 20857 

Contact: 
BEHAVIORAL AND EDUCATIONAL INTERVENTIONS


Drug Abuse Prevention Program/or Runaway Youth 

Description: The purose of this progr is to provide improved and expanded drg abuse 

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, 

Washigton, DC 20201 

Contact: 

Integrated Primary Health Care 
 Drug Abuse Treatment Demonstration Program 

A joint progr between BHCDA and NIA grts money to 21 organzations 

for drg treatment for those at high risk of HI infection. Th 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 s Hospita in Los Angeles works with drgusers aged 12-24. 

Description: 

Contact: Division of Special Populations Progr Development, BHCDA, HRSA, 5600 

Fishers Lane, Rockvile, MD, 20857 

AIDS Prevention Services by Health Providers/or Homeless, Runaway, and NonSchool 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. 

Contact: Division of Services for Childrn with Special Car Needs, MCHB, HRSA, 5600 

Fishers Lane, Rockvile, MD, 20857 

Minority AIDS Education/Prevention Grant Program 

Description: This progr was created to demonstrate the effectiveness of education and 

prevention strtegies tagetig raial and ethnic miorities which: 1) expand the rage of 

community-based and national organizations involved in HI 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. 

Contact: OMH, OASH, 200 Independence Avenue SW, Washington, DC, 20201
AIDS High Risk Adolescent Prevention Program 

This trning progr is dited to youth services workers who come into 

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. 

Description: 

Community Researh Branch, Division of Applied Research, NIDA ADAM, 

560 Fishers Lae, Rockvile, MD, 20857 

Contact: 

Health Education/Risk Reduction (HE/RR) 

The focus of HEIRR progrs is to prevent, reuce, or elimiate high risk 

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 

behaviors may place them at risk of HI. HE 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 

facilties, shelters for runaway and homeless youth, housing projects, community health 

centers, mobile vans, and churches. 

Description: 

Contact: CPS, CDC, Atlanta, GA, 30333 

Minority Initiatives 

Par of the HI/AIS prevention funds awarded to State and local health 

deparents is used solely for special initiatives providing HI prevention services to racial or 

ethnic minorities. In Fiscal Year 1989, 281 organizations whose priar focus is minority 

populations were funded. Twenty-two percent of these organizations worked with youth. 

Description: 

Contact: CPS, CDC, Atlanta, GA, 30333 

Direct Funding of Minority and Other Community-Based Organizations 

Description: In addition to the prevention cooperative agreements awarded to State and local 

health agencies, CDC dictly provides funds and tehnical assistace to minority and other 

community-based organizations (CBOs) in the metropolita statistical areas most heavily 

afected by HI 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.


Contact: CPS, CDC, Atlanta, GA, 30333

United States Conference of Mayors HIVIAIDS Education Grants Program 

With the help of a cooperative agreement with CDC, the United States 

Conference of Mayors has been giving fiancial and tehnical assistace to community-based 

organizations since 1985. Severa of the funded projects taget youth. 

Description: 

Contact: Office of the Deputy Dirctor for HI, CPS, CDC, Atlanta, GA, 30333

School Health Education Program 

The Division of Adolescent and School Health (DASH), within CCDPHP, funds 

al State and 16 local education agencies largely to provide prevention programs for youth 

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, 

and for youth who have special education needs. Progr 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. 

Description: 

Contact: DASH, CCDPHP, CDC, Atlanta, GA, 30333.

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 

national youth-serving, youth employment, and education organizations on HI 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 

national conference on HI and Adolescents, and prouces a varety of publications related to 

adolescent HIY education, includig a life planning curculum, a series of HI and 

Description: 

Out oj the Shaws: Building an Agend and Strategies for 

Preventing HN Injection and AIDS Among Street and Homeless Youth. 

adolescent fact sheets, and 


Contact: DASH, CCDPHP, CDC, Atlanta, GA, 30333
National Coalition of Advocates for Students (NCAS) 

This national organization provides support for HI education in both schools 

and non-trditional settgs for school-aged youth. NCAS has tageted education activities for 

migrt farworker youth in Florida Texas, Mississippi, Nort Carolina, and Washington. 

NCAS also provides HI prevention education to migrt 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. 

Description: 

Contact: DASH, CCDPHP, CDC, Atlanta GA, 30333

National Coalition of Hispanic Health and Human Services Organizations 

(COSSMHO) 

The objective of this cooperative agreement is to mobilze community-based 

organizations to provide HI prevention education tageting out-of-school Hispanic youth. 

COSSMHO has conducted workshops in New York City, EI Paso, Los Angeles, Chicago, and 

San Juan to help community organizations with HI education needs, innovative strategies to 

reach Hispanic youth, and resource identification. 

Description: 

Contact: DASH, CCDPHP, CDC, Atlanta GA, 30333

National Commission on Correctional Health Care (NCCHC) 

The National Commssion on COITectional Health Car serves incarcerated youth 

in detention and cOITectional facilties nationwide. It has conducted an my educational needs 

assessment in more than 1300 facilties serving youth, and provides my education traiing 

sessions for cOITectional facilty providers serving youth. NCCHC wil also conduct a youth 

knowledge, attitudes, and behavior surey. 

Description: 

Contact: DASH, CCDPHP, CDC, Atlanta, GA, 30333

National Network of Runaway and Youth Services (NNRYS) 

Description: The National Network of Runaway and Youth Services provides support for 

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, 

NNRYS developed an HI education curculum entitled Safe Choices 
 for high risk

out-of-school youth. Modules in the curculum are designed for use in street outrach 

progrs, shelters, telephone hotlines, detention centers, and group homes. 

Contact: DASH, CCDPHP, CDC, Atlanta, GA, 30333
National Organization of Black County Officials (NOBCO) 

The objective of this cooperative agreement is to increase the avaiabilty of 

prevention education to Black and other ethnic minority youth residing in urban and rual 

communities acss 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 

year. The HI prevention progr is adptable and suitable for use in school and 

out-of-school settgs. Other activities include national workshops designed to furer 

educate NOBCO members and afilates about the nee for my prevention education at the 

Description: 

local level.


Contact: DASH, CCDPHP, CDC, Atlanta, GA, 30333

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 

The purose of this progr is to provide fmancial assistance to establish or 

strengthen community-based centers that adess the imediate needs (e.g. outreach 

tempora shelter, counseling, and aftercar servces) of runaway and homeless youth and 

Description: 

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 

Washington, DC 20201 

Contact: 
Transitional Living Program for 
 Homeless Youth

The purose of this progr is to provide technical and financial assistace to 

organizations that wil provide comprehensive services and shelter to homeless youth ages 16 

thugh 21 for up to 18 months. The goals of the progr are to promote a transition to 

self-sufciency and to prevent long-term dependency on social services. 

Description: 

Famly and Youth Services Bureau, ACYF, OHDS, 200 Independence Avenue SW, 

Washington, DC 20201 

Contact: 

State Networking on AIDS and Out-of-Home Adolescents 

This project involved technical assistace and consultation services to seven 

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. 

Description: 

Contact: Child and Famy Support Brach, NIMH, ADAMH, 5600 Fishers Lane,

Rockvile, , 20857
NETWORKING 

EXTERNAL WORKSHOPS AND CONFERENCES 

The Deparent has sponsored severa national and regional conferences focusing in whole or 

in par on HI 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 Coordination 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' 

Scope: National (primarly for llS employees) 

Site: Bethesda, MD 

Date: Januar 1989 

Deparbnental sponsor: 


Fifth Annual National Pediatrc AIDS Conference and Follow-up to the 1987 Surgeon General' s Workshop on Children with HlV Infection and Their Families 

Scope: National 

Site: Los Angeles, CA 

Date: September 1989


Deparbnental sponsor: BMCH 

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 

Departmental sponsor: BMCH 

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. 

The National AIDS Program Offce organzes th separte bodes which meet regularly to 

coordiate the Federa response to the HI 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 Promotion), Health (planning and Evaluation), Population Affais, and Health 

(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 representatives from NAPO, Offce of Surgeon General, ADAMH, AHCPR, ASPE, CDC, 

HRSA, ilS, NI, the Health Ca Financing Admnistrtion, the Social Securty Administration, 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 

AIDS. This Panel is chai 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 members. 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 Services 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 attend the meetigs.