Perinatal Initiative to Provide HIV-Positive Women Specialized Support

In 2002, the AIDS Foundation of Chicago (AFC) welcomed the University of Chicago's Children's Hospital and Mount Sinai Hospital as partners in a yearlong program to reduce perinatal HIV transmission.

The goal of the prevention project, which is jointly supported by AFC and the Pediatric AIDS Chicago Prevention Initiative (PACPI), is to improve the health of pregnant HIV-positive women and to reduce the possibility that an infected mother will transmit the virus to her baby during pregnancy, labor, or delivery. Perinatal HIV transmission accounts for 90% of pediatric AIDS cases in the U.S. In 1994, the Pediatric AIDS Clinical Trials Group discovered that when the HIV medication zidovudine (AZT) is dispensed to HIV-positive women during their pregnancy and labor, and to their newborns, the risk of HIV transmission could be reduced by two-thirds. Since this critical medical discovery, pediatric AIDS cases due to perinatal transmission have declined 75% between 1992 and 1998. But, the effectiveness of AZT is dependent upon the individual's adherence to its complex regimen and the maintenance of regular medical visits. To this end, AFC and PACPI have created two new intensive case management positions to ensure that pregnant HIV-positive women get the medical support and counseling they need to sustain their HIV-medication regimens.

Clients will be identified and referred to an intensive case manager, known as a maternal child health specialist, by obstetricians and other health care and social service providers, as well as by AFC-funded case managers. The specialist will provide clients with intensive case management services throughout the term of their pregnancies and six-months after delivery. These services consist of linkages to primary, prenatal, and well-child care, as well as substance abuse treatment and other psychosocial services as needed. At the end of the six-month, post-partum period, clients will be transferred from intensive to non-intensive HIV case management, for further health services needs. AFC anticipates that the case manager to client ratio for the program will be between 1:8 and 1:20 at any given time during the pregnancy and post-partum period.

AFC currently administers two other intensive case management programs for high-risk populations with HIV— the Safe Start program and the Corrections Initiative. Safe Start pairs multi-diagnosed, HIV-positive, homeless clients with intensive case managers to ensure that they get the housing and support services they need, while the Corrections Initiative targets HIV-positive individuals returning from correctional settings and gives them access to the life-stabilizing services they need to make a successful transition back into the community. Each program is based on the intensive case management model that includes frequent client visits and small caseloads.

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Fact sheet (PDF)