The goals of the Grady Health Systems (GHS) Adolescent HIV clinic and seronegative but """"""""high risk"""""""" clinic are to bring unique aspects found in inner-city Atlanta youth to the network. These clinics have a vulnerable population of primarily female, African-American youth where seroprevalence has been determined y adolescent medicine at 5.1/1000 (1). This figure is corroborated by seroprevalence of 4.8/1000 determined independently by Obstetrics in pregnant adolescent females presenting to GHS for care (2). Characteristics of this population include: 1) approximately 2400 high risk African-American youth, primarily female, who regularly present to GHS for care; 2) heterosexual spread of HIV among adolescents primarily from infected male to young African-American females; 3) no evidence in this group of intravenous drug use among the 10-19 year ages; 4) pelvic inflammatory disease as a leading cause of hospital admission (HSCH) of adolescents ranging 10-19 years of age; 5) evidence of despair and poverty from numbers of adolescents admitted for in-patient care for suicide attempts. Despite this background, our HIV infected teen clinical population research protocols during pregnancy and to appointments both in prenatal and in HIV has adhered to research protocols during pregnancy and to appointments both in prenatal and in HIV adolescent clinic. The """"""""at risk"""""""" population has collaborated with peer education groups; 18% of 717 patients seen for acute high risk care in the GHS have kept clinic appointments without reminders. A state-of-the-art clinic for HIV infected men, women, adolescents, and children has allowed multiple disciplines to work together at one site. Adolescent specialists consisting of a peer counselor, social worker, and physician have been able to follow 28 HIV infected, African-American youth and their infants without any """"""""lost to follow-up"""""""". This team approach includes giving access to Pediatric ACTG trials, collaborating with research protocols (CDC perinatal transmission and thymus transplant), working with teen clients to keep appointments, and culturally sensitive education and support groups.
