Knowledge and understanding of the natural history of HIV infection in the adolescent population are limited, and comprehensive adolescent-oriented health care services in the US are few. Although actual AIDS cases in this age group comprise a very small percentage of the total reported, the impact of HIV infection during adolescence is far more serious. A national coordinated policy regarding all facets of health care management for HIV- infected youth needs to be established which addresses the adolescent's developmental complexities and problematic social, economic, and legal barriers. The proposed Adolescent medicine HIV/AIDS Research Network will attempt to provide useful information about HIV infection and its behavioral manifestations in adolescents who have acquired the infection via sexual and drug taking activities. Florida,with athe third highest number of AIDS cases nationwide, has an increased percentage of affected women and minorities, as compared to the US population, and a higher rate of heterosexual contact as the transmission mode. These demographic factors are characteristic of the AIDS cases among adolescents here as well, with the spread of the disease among adolescents in Florida being faster than the national rate also. The unique multiethnic and multicultural composition of the Miami area already has indicated important clinical and research information concerning HIV infection and AIDS in children, pregnant women, and adults. Enlightening data about affected adolescents are forthcoming. The University of Miami has responded to the high rates of HIV infection and AIDS locally by establishing centralized, comprehensive, culturally- sensitive health care services and research facilities, both clinical and basic science. In conjunction with community and social service agencies, ancillary support services have been formulated. Out of necessity, adolescent-specific HIV/AIDS services were established in 1991 by the Division of Adolescent Medicine of the Department of Pediatrics. The Special Adolescent Clinic (SAC) at the University of Miami/Jackson Memorial medical Center currently provides comprehensive, culturally- sensitive health care and support services for HIV-infected adolescents. The expert staff is multidisciplinary, committed, and collaborative with the other HIV/AIDS activities here. Outreach to the community and access to the desired population add further to the existent SAC services. For these reasons, the Division of Adolescent Medicine of the University of miami School of Medicine would be a worthy member of the Clinical Science Group of the proposed national Adolescent Medicine HIV/AIDS Research Network.
