Linkage to Care for HIV-Positive Adolescents: A Multisite Study of the Adolescent Medicine Trials Units of the Adolescent Trials Network

PurposeTo understand linkage to care practices at sites providing clinical services to newly diagnosed HIV-positive adolescents.MethodsQualitative analysis of detailed interviews conducted with 28 personnel involved in linkage to care at 15 sites providing specialty care to HIV-positive adolescents.ResultsWe showed that multiple models exist for linkage to care, and that both formal and informal community relationships are important for successful linkage to care. Stigma was seen as a universal issue, enhancing the importance of the balance of confidentiality and social support. Barriers to care, such as mental health issues, substance use, and transportation, are common.ConclusionsWe conclude that the complexity of linkage to care requires thought and planning as HIV testing is expanded to lower-risk populations.