Creating systems change to support goals for HIV continuum of care: The role of community coalitions to reduce structural barriers for adolescents and young adults

Routine HIV screening, linkage, and retention in health care are nodes of the HIV continuum of care and goals of the National HIV/AIDS Strategy. However, up to 80% of youth are unaware of their HIV status, 29% are linked to and less than 50% are engaged in HIV health care, and fewer maintain viral suppression. To fill these gaps and to address the national call to establish a seamless system for quality HIV health care, the authors describe the processes by which the SMILE Program, with ATN-affiliated Connect-to-Protect (R) (C2P) community coalitions, addressed structural barriers that prevented HIV testing, linkage, and engagement in HIV health care among youth.