CNH HIV Prevention and Treatment Services (HPTS) reaches to a wide range of adolescents and youth at risk for (13-≤21 years) and living with HIV (13-≤24 years) and has served as the main hub for HIV prevention, testing and counseling, and care and treatment for adolescents and youth in the DC region including suburban MD and VA since 1980s. We are firmly integrated within multiple local and regional clinical, governmental, and community partnerships addressing overall youth health including sexual and reproductive health, gender identity, and prevention and treatment of HIV infection in the DC eligible metropolitan area. These partnerships include established long-term relationships with three regional Departments of Health and jointly coordinates Ryan White services and outreach activities with disease intervention specialists for engagement and retention in care. The HPTS Youth PrEP Center closely collaborates with CNH’s two Emergency Departments, Mobile Health Units, Youth Pride LGBTQ Clinic and Community Health Centers and with other regional healthcare and community organizations. We have established clinical partnerships with >20 regional healthcare facilities, such as George Washington University Hospital MedStar Washington Hospital and Whitman-Walker Health. Another important partnership includes CNH-run DC School Services working at 13 middle schools, 17 high schools, and 14 public charter schools, and DC High-School Based Health Centers at the Ballou, Coolidge and Dunbar High Schools. Community partnerships relevant to work in the youth HIV prevention and sexual and reproductive health needs, include >20 organizations, including Latin American Youth Center in DC, Departments of Youth Rehabilitation Services in DC and MD, US Helping US in DC and NovaSalud in VA.
HPTS is integrated with the hospital-based specialty care and have close bidirectional ties with CNH’s Community Pediatric and Adolescent Health Centers. Our multidisciplinary team includes four physicians, two nurse practitioners, five case managers, two psychologists, one psychiatrist, one nutritionist, three patient care navigators, and four research coordinators/data managers. All members of our team are certified in HIV prevention, participate in the quality management and lead individual clinical/research projects. Our integrated clinical and research teams are comprised of staff with multiple cultural, racial and ethnic backgrounds and reflect the diversity of the backgrounds of the populations we serve. Peer support groups are offered for patients and their caregivers on regular bases as well as an array of psychosocial support services including individual and family counseling and working with schools and colleges. A Parent Advisory Committee (PAC) is offered for parental peer support. HPTS at CNH utilizes a status neutral approach for the Community Advisory Board (CAB), comprised of caregivers of children and youth living with HIV, youth living with HIV and youth without HIV. Overall, we provide the ideal platform to ensure and facilitate movement of patients and their families along the HIV prevention to care continuum and research.
Our team is currently running multiple HIV treatment and prevention adolescent studies. Here are the selected examples:
SHIELD, funded by PENTA/ViiV: Clinical trial to assess the safety and efficacy of Fostemsavir administered as part of the antiretroviral regimen in children and adolescents between 6-18 years old who are failing their current antiretroviral therapy.
PREPARE study, funded by NIH/University of North Carolina: An interview and youth advisory board-based program to gather insight into how to ethically conduct research with HIV/co-infected pregnant adolescents.
HPTS Observational Cohort, non-funded: This observational study collects and analyzes diverse social, behavioral, laboratory and clinical characteristics of patients receiving testing and care at HIV Prevention and Treatment Services.
The DC Cohort Study, funded by NIH/GWU: The DC Cohort is a long-term study that has been following about 10,000 consenting patients living with HIV receiving care at 13 large treatment clinics in the District of Columbia, including CNH. Sponsored by NIH/George Washington University (GWU), the project’s goal is to improve the quality of care and treatment of HIV-infect patients at large clinics in the DC area.
Pragmatic Efficacy Trial of mHealth to Improve HIV Outcomes in the DC Cohort (Positive Links): Positive Links is a mHealth platform “that includes patient and provider smartphone apps, a web portal for clinic staff and providers to manage patient cohorts, an online implementation guide, and a learning management system to train and certify clinic staff.” The purpose of this study is to assess efficacy and usability of the mHealth platform with regards to how it may potentially affect continuity of care and viral suppression.
Emergency Department HIV Screening and Outreach Program: Since 2009, Children’s National has implemented a universal HIV screening program for teens aged 13 years and older who come to our Emergency Departments at the main campus and United Medical Center. This study collects the data on testing and outcomes and contributes to the design of future interventions to reduce the incidence of HIV and sexually transmitted infections among the youth in our community.