New York University's Vincent Guilamo-Ramos calls for specially tailored, or differentiated, HIV prevention and treatment services for adolescents and young adults, in National Academy of Medicine paper.

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Despite the significant progress made in the fight against HIV/AIDS in the United States, the number of young people being diagnosed with HIV continues to increase. To meet the federal government’s goal of eliminating HIV/AIDS in the U.S. by 2030, the dominant models for prevention and treatment must take into account the differentiated needs and challenges of adolescents and young adults, and particularly those of racial, ethnic, and sexual-orientation minorities, writes New York University professor Vincent Guilamo-Ramos in a paper published today (March 25) by the National Academy of Medicine (NAM).

Globally, differentiated approaches are widely used for HIV service delivery, resulting in better care and better resource allocation. The NAM Perspectives paper by Guilamo-Ramos (PhD, ANP-BC, AAHIVS), who is a professor at the Silver School of Social Work and the director of its Center for Latino Adolescent and Family Health (CLAPH), discusses in detail why the U.S. should adopt them.

The paper highlights what Guilamo-Ramos calls “persistent and largely overlooked” disparities in HIV prevention and care for adolescents and young adults. It identifies limitations in common prevention and treatment paradigms. And it proposes a differentiated care framework that can be adapted to the distinct ecological and developmental factors shaping the unique needs of racial, ethnic, and sexual-orientation minority adolescents and young adults.

As opposed to a “one size fits all” approach, differentiated care tailors HIV service delivery across the prevention and care continuum in order to meet the needs, preferences and expectations of key populations and hard-to-reach individuals. Shifting the paradigm for adolescents and young adults to differentiated care “warrants implementation and evaluation as part of reinforced national efforts to end the HIV epidemic in the United States by 2030,” Guilamo-Ramos writes.

The March 25 paper, “Shifting the Paradigm in HIV Prevention and Treatment Service Delivery Toward Differentiated Care for Youth.” was co-authored with Marco Thimm-Kaiser and Adam Benzekri of CLAFH, and Donna Futterman, MD, of the Adolescent AIDS Program at the Children’s Hospital at Montefiore.

“To address the persistent treatment and prevention disparities that threaten efforts to end the HIV/AIDS epidemic in the United States, innovative and adolescent- and young adult-specific care models are sorely needed,” concludes Guilamo-Ramos, a nurse practitioner who specializes in the care of HIV-positive and at-risk adolescents, and the director of the Pilot and Mentoring Core at the Center for Drug Use & HIV Research, NYU College of Global Public Health.

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