Infectious Diseases Among the Homeless Pediatric PopulationThe parallel universe of homeless and HIV-positive youth☆,☆☆,★
Section snippets
What is it like to be homeless and HIV+?
One study of 327 homeless youth between the ages of 14 and 21 noted that 88.7 percent were sexually active. Twenty-nine percent reported having had sexual intercourse with twenty or more partners during their lifetimes. Forty-four percent engaged in “survival sex” (ie, the exchange of sex for money, drugs, or a place to stay). Fifty-three percent reported having had one-time sexual encounters. Thirty percent reported having had sex with someone known to have a sexually transmitted disease, and
Barriers to obtaining care/reasons for noncompliance
To begin to make a positive impact on the lives of these teens, including convincing them of the necessity of getting proper medical care for HIV, AIDS, STDs, and other infections, healthcare providers must be able to listen to and understand without criticism and judgment what it is truly like to live their lives.8, 10 Implementing innovative models of service provision requires that healthcare providers meet these youth where they already are, not where we would want them to be.11, 12
Learning to see the invisible: An intervention program
These two parallel universes began to converge when medical providers at Baylor College of Medicine/Texas Children's Hospital who specialize in treating HIV+ youth (who were not necessarily homeless) approached a multidisciplinary team that specializes in working with adolescents. Within this team, the clinical psychologist assumed the challenge of devising a psychological intervention that would capture the attention, motivation, and, most of all, trust of the teens with HIV. The current ten
Conclusion
Healthcare providers have a rare opportunity to “walk in the shoes” of these challenging youth, and those who open themselves to truly listen to these youth may just suddenly “slip into a parallel universe” where what once was invisible, now is visible. By breaching the gap that exists between the two universes, physicians have the potential to communicate to these youth, in terms they understand, the medical care that is available to them and their need to avail themselves of it. As
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Cited by (2)
Comparison of HIV risks among gay, lesbian, bisexual and heterosexual homeless youth
2008, Journal of Youth and Adolescence
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Address reprint requests to Deborah Ebner, PhD, Baylor College of Medicine, Department of Pediatrics, Section of Adolescent Medicine, Texas Children's Hospital, Medical Staff, Houston, TX 77030; e-mail: [email protected]
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This project was supported in part by the Baylor Center for AIDS Research Core Support Grant number AI36211 from the National Institute of Allergy and Infectious Diseases, as well as by the NIH Social and Scientific (Supplement) Pediatric AIDS Clinical Trial Group NIAID 1 U01 A1 27551 13. Special thanks go to the Office of Development Grant Award from Texas Children's Hospital to provide psychological services to indigent children with HIV/AIDS.
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