Introduction: what youth need—adapting HIV care models to meet the lifestyles and special needs of adolescents and young adults

Although adolescents commonly participate in behaviors that potentially expose them to an HIV infection they are not commonly tested as a result of these behaviors. Furthermore many of those who are tested never return to receive their test results and fewer still are successfully linked to a continuum of care. The ideal model proposed above is encumbered by the following barriers. Impediments to HIV Testing Youth lack (a) knowledge about the consequential link between a given behavior and HIV infection (b) a belief that a given behavior that can cause HIV infection will personally affect them and (c) a perception that dangerous consequences are associated with a behavior and (d) psychological coping strategies that would enable then to sustain goal-directed behavior necessary for the testing process. Furthermore they fear the testing process and the ultimate life-threatening effects of an HIV diagnosis. Youth who do decide to seek testing are encumbered by additional barriers: lack of knowledge of the available sources of HIV testing long waiting times unanticipated costs and lack of health insurance “youth-hostile” testing sites and testing staff and legal requirements that restrict minors’ rights to grant informed consent. (excerpt)