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editorial
. 2003 Mar;95(3):196–200.

Nonstigmatizing ways to engage HIV-positive African-American teens in mental health and support services: a commentary.

Maureen E Lyon, Kathy Woodward
PMCID: PMC2594413  PMID: 12749679

Abstract

This commentary illustrates a hospital/adolescent-clinic based model for providing support services and for increasing medical adherence among HIV positive inner city African-American adolescents. This commentary reviews the racial/ethnic disparities in HIV disease among adolescents and describes a successful program model for overcoming stigma. Traditional support groups were rejected by youth with HIV/AIDS. Seven elements common to successful programs were identified. Successful programs built on designs described in the research literature. Focus groups composed of HIV-positive adolescents identified what they wanted and needed. Stigmatizing labels were avoided in naming programs. Practical barriers to access, such as transportation and childcare, were eliminated. Programs were skills oriented, culturally sensitive, and life affirming, focusing on healthy living. HIV-positive inner city African-American youth can be successfully recruited and engaged in hospital based programs. Although these programs were qualitatively evaluated by youth as successful and attrition was low and attendance averaged 50%, rigorous quantitative research is needed to evaluate the effectiveness of such programs. We need quantitative research to successfully advocate for government funding. Stigma needs to be addressed openly in public health. Future research is needed to evaluate interventions to overcome the health consequences of stigma on utilization of available medical and mental health services.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. D'Angelo L. J., Abdalian S. E., Sarr M., Hoffman N., Belzer M., Adolescent Medicine HIV/AIDS Research Network Disclosure of serostatus by HIV infected youth: the experience of the REACH study. Reaching for Excellence in Adolescent Care and Health. J Adolesc Health. 2001 Sep;29(3 Suppl):72–79. doi: 10.1016/s1054-139x(01)00285-3. [DOI] [PubMed] [Google Scholar]
  2. Freimuth V. S., Quinn S. C., Thomas S. B., Cole G., Zook E., Duncan T. African Americans' views on research and the Tuskegee Syphilis Study. Soc Sci Med. 2001 Mar;52(5):797–808. doi: 10.1016/s0277-9536(00)00178-7. [DOI] [PubMed] [Google Scholar]
  3. Geronimus A. T. To mitigate, resist, or undo: addressing structural influences on the health of urban populations. Am J Public Health. 2000 Jun;90(6):867–872. doi: 10.2105/ajph.90.6.867. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gonzalez S., Steinglass P., Reiss D. Putting the illness in its place: discussion groups for families with chronic medical illnesses. Fam Process. 1989 Mar;28(1):69–87. doi: 10.1111/j.1545-5300.1989.00069.x. [DOI] [PubMed] [Google Scholar]
  5. Lyon M. E., Silber T. J., D'Angelo L. J. Difficult life circumstances in HIV-infected adolescents: cause or effect? AIDS Patient Care STDS. 1997 Feb;11(1):29–33. doi: 10.1089/apc.1997.11.29. [DOI] [PubMed] [Google Scholar]
  6. Murphy D. A., Durako S. J., Moscicki A. B., Vermund S. H., Ma Y., Schwarz D. F., Muenz L. R., Adolescent Medicine HIV/AIDS Research Network No change in health risk behaviors over time among HIV infected adolescents in care: role of psychological distress. J Adolesc Health. 2001 Sep;29(3 Suppl):57–63. doi: 10.1016/s1054-139x(01)00287-7. [DOI] [PubMed] [Google Scholar]
  7. Murphy D. A., Wilson C. M., Durako S. J., Muenz L. R., Belzer M., Adolescent Medicine HIV/AIDS Research Network Antiretroviral medication adherence among the REACH HIV-infected adolescent cohort in the USA. AIDS Care. 2001 Feb;13(1):27–40. doi: 10.1080/09540120020018161. [DOI] [PubMed] [Google Scholar]
  8. Pao M., Lyon M., D'Angelo L. J., Schuman W. B., Tipnis T., Mrazek D. A. Psychiatric diagnoses in adolescents seropositive for the human immunodeficiency virus. Arch Pediatr Adolesc Med. 2000 Mar;154(3):240–244. doi: 10.1001/archpedi.154.3.240. [DOI] [PubMed] [Google Scholar]
  9. Smith M. D. HIV risk in adolescents with severe mental illness: literature review. J Adolesc Health. 2001 Nov;29(5):320–329. doi: 10.1016/s1054-139x(01)00265-8. [DOI] [PubMed] [Google Scholar]
  10. Treisman G. J., Angelino A. F., Hutton H. E. Psychiatric issues in the management of patients with HIV infection. JAMA. 2001 Dec 12;286(22):2857–2864. doi: 10.1001/jama.286.22.2857. [DOI] [PubMed] [Google Scholar]
  11. Valleroy L. A., MacKellar D. A., Karon J. M., Rosen D. H., McFarland W., Shehan D. A., Stoyanoff S. R., LaLota M., Celentano D. D., Koblin B. A. HIV prevalence and associated risks in young men who have sex with men. Young Men's Survey Study Group. JAMA. 2000 Jul 12;284(2):198–204. doi: 10.1001/jama.284.2.198. [DOI] [PubMed] [Google Scholar]

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