The AAP: 26 Years of HIV Support for At-Risk Youth & Expert Training for Health Care Providers

The 411: Since 1989, the Adolescent AIDS Program has been a go-to local and national resource for HIV-positive and at-risk HIV-negative youth, their families, and health care providers. Thanks to the success of its multidisciplinary clinic team, research projects and initiatives like the Umbrella Program for LGBTQ Youth & Families and the ACTS (Advise, Consent, Test, Support) system for routine HIV testing, the AAP is saving lives and making great contributions to the public health fight to end the HIV/AIDS epidemic.61% of teens have had sex by age 18

, and 60% of HIV-positive youth don’t know they’re infected, aren’t receiving treatment, and can unknowingly spread the virus to someone else. With young men who have sex with men (especially Black and Latino youth) comprising the majority of new HIV cases, the Adolescent AIDS Program (the AAP) has always focused its energy on caring for those youth most at-risk.

This may be news to some, but the AAP is well aware of the stats and is working hard to identify HIV-positive youth, engage them in care and prevention and spread the word that it is possible to end the HIV epidemic in our lifetimes.

The AAP knows most people become sexually active during their teen years, often when they don’t know much about their own bodies, and that young people have some of the highest rates of STIs, which puts them at increased risk for HIV.

The AAP also knows adolescents and young adults are just beginning to learn how to take responsibility for themselves, so in the context of health care, they need specialized medical and psychosocial care to help them navigate health systems.

Donna Futterman, Adolescent AIDS Program Director

With an experienced team of 20+ medical and mental health providers, research staff, training experts, and peer educators at the wheel, the AAP is able to do just that by providing accessible medical care, groundbreaking research, training for doctors, nurses, and the like, community outreach, and more. With the availability of treatment that can help HIV+ youth live a healthy, full life, this care is needed more than ever.

We got the ins and outs of how the AAP does it all from the program’s Director, Donna Futterman, and its Director of Communications and Special Projects, Stephen Stafford. We’ll talk about specific services for teens and health care providers, as well as the AAP’s goal to keep every generation informed, but feel free to click the links below if you want to jump ahead.

Whether it’s clinical services, confidential counseling, or social marketing campaigns, starting with the right words makes all the difference, and that’s what the AAP has been doing from the very beginning.

Instead of using preachy phrases and medical terms most youth don’t use or understand, the AAP tries to reach youth using their own constantly evolving language. In some of the AAP’s past campaigns, “making love” became “knockin’ boots” or “HIV education” became “The Deal.”

The AAP offers dozens of affordable or even free services for teens.

“We don’t literally always speak the same language as young people, so if we want to reach them, they need to know these messages are aimed at them by using their words and images,” Futterman said.

While the words are important, the quality of resources offered is equally as important, and AAP can’t be beat when it comes to that either. We’ll delve deeper into medical, mental, and LGBTQ specifics. Note: Every AAP service is either free or covered by insurance with Medicaid and most health insurance plans!

Click the links below to learn about the services you’re most interested in.

Medical Care

Perhaps the most impressive aspect of the AAP is the youth-friendly, comprehensive medical care provided to teens and young adults ages 13 to 24, including those who are HIV positive, as well as HIV-negative youth who are at risk for contracting the virus.

We’ve included bullet points so you can get a better idea of what’s available.

Clinical Services:

• HIV testing and risk reduction counseling
• Comprehensive health care
• Easy referrals for psychiatry and gynecology
• Services available in Spanish
• And more

HIV Counseling and Testing:

• Confidential and free
• Oral fluid testing available (no needles used!)
• Referrals to mental health services, primary care physicians, etc.
• And more

For HIV-Positive Youth:

• HIV-specific care, including medications and monitoring (T-cells & viral load)
• Immunizations
• Out-patient assessment and treatment of acute medical conditions
• And more

Mental Health Care

Good mental health matters just as much as good medical health, so the AAP provides a wealth of tools for adolescents to take advantage of, including:

• Individual, family, and couples therapy
• Psychiatric assessment and treatment
• Annual youth retreats
• And more

LGBTQ Care

While the medical and mental health resources listed above can also be very helpful to LGBTQ teens, specific services like disease screenings, immunizations, support, and more are also available. For transgender youth, services include support in understanding who you are, access to gender-affirming hormones, and more.

“For transgender youth, you can just imagine some kids have grown up their whole lives knowing their body didn’t match their inner self,” Futterman said. “It’s very important to first make sure the young person has a safe place to stay, and then work with them and their parents to outline a medical and mental health plan that nurtures who the child feels they are.”

The AAP offers several LGBTQ-specific resources, including the Umbrella Program for LGBTQ Youth & Families.

She added that while access to comprehensive and positive sex education is limited for almost all teens, LGBTQ teens and young adults often don’t receive the same support as their heterosexual counterparts, and they face bigger challenges, as well as a significant amount of isolation and rejection.

To address these issues, the AAP has crafted several programs just for them, including the Umbrella Program for LGBTQ Youth & Families, which works with local and national youth groups to get the dialogue going about issues like bullying, safe sex, dating advice, and depression.

“We look to work with those in the community who will support those kids, as well as work with the young people and their own families, so they can have love and support and reach their full potential,” Futterman said.

HIV-positive youth have to face a ton of problems as it is, but with the care of a good medical professional, a weight can be lifted off their shoulders, which is why the AAP dedicates itself to helping doctors, nurses, social workers, and everyone in between learn more about new advancements in HIV treatment and prevention, as well as the unique stressors that apply to LGBTQ adolescents.

“One of the big things we’re trying to do is inform all health care providers about the need to offer HIV testing more routinely to youth and also to inform them of the amazing new advances in bio-medical prevention, such as pre-exposure prophylaxis or PrEP (one pill a day that reduces risk of contracting HIV by more than 95%). There’s a lot of work to do to educate both providers and patients about the protective benefits of PrEP,” Stafford said.

If you’re not a medical professional but are still deeply involved in your community and want to know about resources just for you, feel free to click the “Community Training” link.

Medical Training

It doesn’t matter if you’re a physician or nurse practitioner — AAP medical training sessions are led by the best of the best. The organization even encourages spreading the knowledge by taking what you learn and adapting it for outside conferences, clinical meetings, and more.

Courses and initiatives include:

Youth and HIV Dynamics:

An overview of the epidemiology of rising rates of HIV among youth and how to respond from a clinical and prevention perspective

LGBTQ 101:

A review of terminology, structural oppression and resulting health disparities, and best practices for creating a LGBTQ-friendly clinic

Hormone Therapy:

An intro for providers who want to initiate hormone therapy for transgender clients

ACTS:

In response to the CDC’s call for routine HIV testing in medical settings, the AAP developed ACTS (Advise, Consent, Test, Support) in 2003 to help providers integrate HIV testing into other routine health services they provided patients.

AAP programs like ACTS have a huge influence on the medical field.

ACTS has been successfully used across the United States and in South Africa. The AAP is currently working with the leadership of its parent hospital, Montefiore Medical Center, to scale up routine HIV testing in the inpatient, outpatient, and emergency departments.

“We are training providers — nurses, doctors, social workers — to offer the test routinely. That way it keeps HIV in the forefront of medical practice and helps us to eliminate missed opportunities to diagnose HIV and also improves our ability to link those who are positive to care and support,” Futterman said.

Community Outreach & Training

The AAP is dedicated to community education and collaboration, and they continue to strengthen that bond through services like:

• Sex education and sexual health services for all teens
• LGBTQ 101: an intro to topics like sex, gender, and sexual orientation
• LGBTQ-Inclusive Sex Education: incorporating LGBTQ needs into safer sex discussions
• And more

While eliminating new cases of HIV in teenagers is a lofty goal, the AAP is up to the challenge. Treatments have never been better at prolonging lives and substantially reducing an HIV-positive person’s chances of infecting others. Likewise, PrEP has the potential to almost vaccinate HIV negative youth against the disease.

“It’s still a big deal to have HIV, to have an illness that you have to treat every day, that you might give to a loved one or child, that affects your life forever,” Futterman said. “But we also want to give a message of hope.”

And their main way of providing that hope is to continually innovate, to fit the times by staying abreast of current medical and mental health advances, by reaching out to youth where they are, by using the same methods of communication that teens use, by recruiting youth-centered industries, such as music and fashion, to join the fight, and more.

“We have to approach each generation of new people with the same passion as we did before.”

“We have to approach each generation of new people with the same passion and updated messages as we did before, or we shouldn’t be surprised that young people continue to have the highest rates of new cases,” she said.

We have the tools to end the HIV/AIDS epidemic. If we are going to be the generation that achieves this goal, we all must do our part to educate ourselves about prevention and treatment options, get tested, fight for better policies, and be there for each other.

“We realize that adolescence is a time of experimentation,” Futterman said. “We want to find ways that support youth in their explorations but keep them as safe as they can be kept.”

To learn more about the Adolescent AIDS Program, visit adolescentaids.org.