This proposal is for the University of Puerto Rico, School of Medicine, Pediatric HIV/AIDS Program to become a Unit of the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). The Pediatric HIV/AIDS Program has extensive experience in the development and implementation of children, adolescents and perinatal clinical trials. The program has been a site for the Women and Infants Transmission Study since 1988, and a Pediatric AIDS Clinical Trials Unit since 1992. As participant of the PACTG and WITS the unit has excellent performance in the areas of recruitment, retention, and compliance with clinical research requirements. The program has extensive experience in the recruitment of HIV positive, as well as healthy adolescents to clinical trials. The adolescent clinic was established three years ago, and consists of an interdisciplinary staff of expert health professionals. At present our unit serves 65 HIV infected adolescents, 40 at our adolescent pediatric unit, and 25 at the OBY-GYN HIV female clinic. The adolescents receive complete medical care including, dental and nutritional evaluation, gynecologic assessment, supportive psychologic intervention, peer support group, and referrals to other medical and community services as needed. Some of the innovations to implement the ATN goals will be, to strengthen the established agreements with community based organizations to improve outreach activities, establish an Internet web page to access the adolescent population, implement interactive activities (music, dance, drama) developed by the adolescent participant, establish a family members and partners group sessions to discuss issues related to the adolescent participants and to help in the planned activities. A young peer-coordinator will be recruited to be involved in all clinic and outreach activities, as well as to assure adequate recruitment and retention through innovative ways such as telephone, beepers and e-mail networks. Our unit will also strengthen the Community Advisory Board to include the participation of the adolescent population. Our goal is to become providers of gold standard adolescent HIV research and services in Puerto Rico and the Caribbean region.
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