The rising incidence of HIV/AIDS in the adolescent and young adult population in the United States is alarming. Risk-taking behaviors associated with this developmental period contribute to the increase via drug abuse, multiple sexual partners, concurrent sexually transmitted diseases, and in some cases, sexual abuse. In Memphis and the surrounding area, a rapid increase in the number of adolescents infected via these routes is occurring. Overwhelmingly the HIV/AIDS adolescent population in Memphis is female and African-American. They have become infected via heterosexual contact, most often with older HIV-infected men. Often these liaisons result in pregnancy. The relative lack of information about HIV/AIDS in adolescents, including biologic behavior of the infection, effects on growth and development, and unique problems in developing treatment regimens and insuring compliance has made designing clinical trials in this population difficult. Therefore, additional information is imperative to develop a scientifically sound, meaningful research agenda. St. Jude Children's Research Hospital (SJCRH) is an ideal site for a clinical science center in the adolescent medicine HIV/AIDS research network. It is a large research center devoted totally to the investigation of catastrophic disease of children and adolescents since 1962. This institution has provided comprehensive care for adolescents enrolled on institutional pharmaceutical, and pediatric AIDS clinical trials group (ACTG)-sponsored protocols since 1988. Using the model of the comprehensive cancer center for our HIV/AIDS program, many disciplines and subspecialists are available within the institution and actively participate in the care of our patients. Within our clinic and through our ongoing collaboration with other clinical sites within the Memphis area, including the county and state health departments, adult HIV/AIDS care providers, and the Memphis AIDS consortium, we have access to the majority of HIV-infected adolescents in this area as well as the proven capabilities for successful conduct of clinical research efforts. In addition, SJCRH is also capable of providing significant scientific contributions to support the research agenda of this effort in the future, notably in the areas of pharmacology.
