Service Use Patterns of Youth with, and at High Risk for, HIV: A Care Typology

Abstract

This paper uses confirmatory structural equation models to develop and test a theoretical model for understanding the service utilization history of 4679 youth who received services from 10 national HIV/AIDS demonstration models of youth-appropriate and youth-attractive services funded by the Special Projects of National Significance (SPNS) Program, HIV/AIDS Bureau, Health Resources and Services Administration. Although the projects differ from one another in the areas of emphasis in their service models, each is targeted to youth at high risk for HIV, or those youth who have already contracted HIV. Collectively, the projects represent a comprehensive adolescent HIV service model. This paper examines the characteristics of the services provided to young people ranging from outreach to intensive participation in medical treatment. Major typologies of service utilization are derived empirically through exploratory factor and cluster analysis methods. Confirmatory structural equation modeling methods are used to refine the exploratory results using a derivation and replication strategy and methods of statistical estimation appropriate for non-normally distributed service utilization indicators. The model hypothesizes that youth enter the service system through a general construct of connectedness to a comprehensive service model and through service-specific methods, primarily of outreach or emergency services. Estimates are made of the degree to which a comprehensive service model drives the services as opposed to specific service entry points.

HIV Services Utilization in Los Angeles County, California

“…Huba et al (2000) using data from the Special Projects of National Significance Program evaluated several programs that were targeted specifically to youth at high risk for acquiring HIV. Integrated service delivery networks were used to develop differentiated paths of service that occurred among the youth accessing services.…”

A Study of the Quantitative Assessment of the Perception of Youth HIV Youth Services

“…More than half of the 14,000 people newly infected each year are under 25 years of age; most of which are female. However, despite the disproportionate burden youth carry, studies show (Huba et al, 2000) that youth are more likely than adults to adopt and maintain safe behaviors; however, young people are routinely disregarded when strategies on HIV/AIDS are drafted, policies made and budgets allocated (Office of National AIDS Policy [ONAP], 2003). Youth between the ages of 13 and 24 in the United States are at unrelenting risks for HIV infection, particularly youth of minority races and ethnicities (Coyle et al, 2004;CDC, 2010).…”

“…Healthcare services utilization is of utmost importance in minimizing social support and medical care needs for youth infected with the virus that causes HIV. Research has confirmed the benefits of early diagnosis of HIV/AIDS and the literature regarding health care utilization speaks to a number of studies related to HIV care services utilization for adults (Kellerman et al, 2006;Huba et al, 2000). Conversely, there was a dearth of articles that addressed the HIV health care services utilization for HIV positive youth 13 to 24 years of age.…”