The University of California, San Diego (UCSD) has joined a growing list of universities and medical facilities sponsoring youth and adolescent-centered HIV support programs.

Researchers at UCSD’s Youth HIV Program are now involved in a national project called Connect to Protect (C2P), which is part of the Adolescent Medicine Trials Network (ATN) for HIV/AIDS Interventions.

There are 15 sites throughout the United States and Puerto Rico and two others in California including the Children’s Hospital of Los Angeles and the University of California at San Francisco.

The ATN aims to analyze how youth and their communities are affected by the HIV/AIDS epidemic, and was established to conduct clinical trials and prevention research independently and in collaboration with existing research networks like the AIDS Clinical Trials Groups. The overall goal of ATN is to care for children, young adults and teens with HIV, search for ways to prevent the virus from spreading among these groups, and ensure they are represented in research related to HIV prevention, treatment and care.

UCSD’s Youth HIV Program and C2P project is housed within the Mother, Child & Adolescent HIV Program, which also includes the Antiviral Research Center, a non-profit university-based clinical trials unit that provides comprehensive health care, patient education, counseling, case management and community education on multiple topics related to HIV/AIDS.

The National Institute of Health directly finances the ATN and the C2P project. Monies from the Health Services Resource Administration’s (HRSA) Ryan White CARE Act fund many of the services performed through the Mother, Child & Adolescent HIV Program.

The C2P project provides a full range of services to youth ages 12-24 who are at risk or living with HIV, including medical care, personal and confidential HIV care, birth control, STD treatment as well as case management. According to the Centers for Disease Control and Prevention (CDC), it is estimated that each year half of all new HIV infections in the U.S. occur in those under the age of 25, translating into approximately 20,000 cases annually.

Mauricio Perez, youth outreach specialist at UCSD’s Youth HIV Program, explained youth in this age group are often disenfranchised without proper supervision.

“I think the significance is that it highlights a greater need for that population aside from HIV prevention – that there’s a greater need for education and awareness. That there’s a greater need for the development of social skills, [and] that there’s a greater need for mental health services to be applied to the population,” Perez said. “The population is severely underserved in so many different capacities, which in all of those capacities really do affect a person’s behavior.”

Researchers at C2P have conducted epidemiological mapping of San Diego to determine where young people are most at risk for contracting HIV, and where to focus their prevention efforts. The research team will be surveying young people from these high-risk areas to learn more about their risk behaviors and social sexual networks. Sero-prevalence testing will then be conducted, which entails actually testing the target youth population for HIV.

“Throughout the process we have been and will continue to work with the community to implement the project and develop, as a team, the best prevention strategies for our community,” said Stephanie Lehman, C2P’s project coordinator. “With these details in hand, Connect to Protect and its partners will create a blueprint for action that aspires to transform San Diego’s physical and social environment in ways that can, for the long-term, curb the spread of HIV among young people.”

C2P’s strategy is to develop partnerships that build upon the insights and skills of researchers and the community, and has 25 local community partners including San Diego Youth and Community Services, Family Health Centers, Hillcrest Youth Center, San Diego County Office of AIDS Coordination, San Diego County Office of Public Health HIV/STD Division, San Diego Job Corp and the Union of Pan Asian Communities.

Brian Hayes is a field research manager at UCSD Youth HIV Program’s City Heights location. As part of Phase II of C2P’s clinical trial, which began in 2003, Hayes solicits community partner input to locate specific locations where at-risk youths, ages 12-24, may be recruited for interventions.

Community partners will also provide the C2P staff with information on known high-risk locations in the city. The interviews will gather information on HIV risk behaviors, social networking patterns and HIV prevalence among the youth at these locations. This information will then be shared with community partners during scheduled group meetings.

“City Heights was determined to be the area that had the highest youth population but the fewest resources for HIV,” Hayes said. “The whole goal is to establish systematic, permanent structural changes into the community. Let’s go into the community and figure out how we can link these connections, these groups together and these agencies together to change the way the system works.”

Hayes said the work C2P is doing is more important than just aiding in safe-sex prevention behavior.

“Now it’s no longer just, ‘here take a condom.’ These kids are given these messages about HIV and self-esteem and linking substance abuse with HIV and linking mental health and all these other issues together, getting these structural changes in place,” he said.

The C2P staff draws from federal, state and local resources to identify at-risk youth while simultaneously creating a profile of the community resources that are available to them. They compare disease and risk rates with service availability, neighborhood strengths and needs. Researchers and community partners can then focus on the prevention strategies that are most needed to protect the health of youth.