These high risk behaviors are precipitated by a cycle resulting from no home, no work, and no family support and consisting of drug abuse and risky sexual behaviors. Covenant House planned a holistic program addressing the social, psychological, spiritual, and medical needs of adolescents with HIV infection. A new facility was constructed, and members of a multi-disciplinary staff recruited. The special-needs program provides medical care to arrest or slow the disease process, psychosocial and life management skills to foster a healthier lifestyle and modify high risk behaviors, and spiritual support to help cope with issues of death and dying.