The Boston HAPPENS program: needs and use of services by HIV-positive compared to at-risk youth, including gender differences

• Published in: Evaluation and program planning Vol. 23; no. 2; pp. 187 - 198
• Main Authors: Woods, Elizabeth R, Samples, Cathryn L, Melchiono, Maurice W, Keenan, Peter M, Fox, Durrell J, Chase, Louise H, Burns, Michelle A, Price, Virginia A, Paradise, Jan, O’Brien, Rebecca, Claytor, Richard A, Brooke, Robyn, Goodman, Elizabeth
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-05-2000; Elsevier
• Series: Evaluation and Program Planning
• Subjects: Acquired Immune Deficiency Syndrome; Adolescents; At-risk youth; Health Education; Health Services; HIV care; Homeless; Massachusetts (Boston); Sex Differences; Sexuality; Social Services; Special projects of national significance program; Massachusetts (Boston); Special projects of national significance program; HIV care; Homeless; At-risk youth; Adolescents; Health services
• ISSN: 0149-7189
• DOI: 10.1016/S0149-7189(00)00007-0

Objective: The Boston HAPPENS (HIV Adolescent Provider and Peer Education Network for Services) Program is a linked services network of care for HIV-positive, homeless, and at risk youth in Metropolitan Boston funded by the Special Projects of National Significance Program. This report studies the needs and use of services by HIV-positive youth compared with negative and untested at-risk youth, including gender differences.
Design: Providers collected information prospectively at outreach and services encounters, including demographic information, risk behaviors, and service utilization data.
Results: Youth (
N=1044) were 19.6±3.0 years old; 38% male; 43% youth of color; and 4% self-identified as gay/lesbian/bisexual and 11.0% as homeless and/or runaway youth. HIV-positive clients (
N=26) were more likely to use a range of network related health services. HIV-positive young women were more likely to report previous pregnancy (21% vs 5%,
p=0.04) or sexual contact with high risk partners such as an injection drug user (57% vs 6%,
p=0.0009), an HIV-positive person (
p<0.00001), or survival sex (33% vs 8%,
p=0.04) than the other young women. HIV-positive young men were more likely to be youth of color (75% vs 43%,
p=0.04) and self-identify as gay or bisexual (42% vs 4%,
p=0.005), and to report same sex partners (80% vs 29%,
p=0.03) and substance use (100% vs 26%,
p=0.006) than other young men. Youth seen at an outreach site were 10 times as likely to access medical care through the program (95% CI, 6.9–14.6).
Conclusions: HIV-positive youth are accessing coordinated care and there are gender differences in the needs for services. Health care policies should facilitate the development and evaluation of comprehensive, youth-specific health services for these hard to reach populations.