SPOT (supporting positive opportunities with teens): Integrating HIV and STD testing, treatment and prevention with positive youth development

Issues: St. Louis experiences high sexually transmitted disease rates with the majority of cases occurring among 15-24 year olds. In addition 25% of the new HIV infections occur among 13-24 year olds. No agency combined health and social services solely for youth in the metropolitan area. Description: In the SPOT's first year of operation, 1882 unduplicated youth were served and 1238 youth were tested, with a 97% positive treatment rate. 161/1238 (13%) were positive for Chlamydia, 40/1238 (3.2%) were positive for gonorrhea, 16/931 (1.7%) were positive for syphilis and 15/ 987 (1.5%) were positive for HIV. Oraquick onsite testing was used. All 15 youth who tested positive for HIV met with linkage to care case managers and 12/15 youth engaged in medical care. 19,000 units of free service including: STD/HIV testing, mental health, case management, job counseling, and contraception were provided by a multidisciplinary team. Lessons Learned: Adherence to the principles of positive youth development engages youth needing health and social services in a community facing a high STD and HIV prevalence among youth. Collaborating with youth serving community partners and local and state health departments enhances meaningful access to youth services. A multidisciplinary team is needed to meet the needs of youth accessing services in a high engagement strategy. Recommendations: Intensive case management and case finding for those at highest risk will be important next steps in our efforts. Ongoing youth leadership and youth advocacy are needed to expand the program and keep it relevant to the community served.