RESUMEN

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

Asunto(s)

Servicios de Salud del Adolescente/organización & administración , Manejo de Caso/organización & administración , Seropositividad para VIH/terapia , Accesibilidad a los Servicios de Salud , Adolescente , Servicios de Salud del Adolescente/normas , Actitud del Personal de Salud , Manejo de Caso/normas , Niño , Ensayos Clínicos como Asunto , Confidencialidad , Seropositividad para VIH/psicología , Humanos , Entrevistas como Asunto , Estudios Multicéntricos como Asunto , Puerto Rico , Investigación Cualitativa , Derivación y Consulta/organización & administración , Derivación y Consulta/normas , Estigma Social , Apoyo Social , Estados Unidos , Adulto Joven