Objectives: This paper describes and compares three innovative methods for preventing perinatal HIV transmission. Each of these strategies has been developed based on an in-depth assessment of the strengths and weaknesses of existing prevention approaches, and the needs of the populations they serve. Methods: Florida expanded an existing outreach program to include women in jails in several high-prevalence counties. Incarcerated women were offered testing for pregnancy and HIV and linked to medical and supportive services. One Connecticut hospital sought to increase prenatal HIV testing rates by requiring HIV test results in the electronic medical records. This program is being expanded to other hospitals throughout the state. Louisiana has implemented a systematic review of perinatal data in order to identify potential programmatic enhancements. This review has led to the perinatal fast track system, designed to quickly identify HIV-infected pregnant women and connect them to care. Results: Each program demonstrated improvements in indicators related to prevention of perinatal HIV transmission, such as increased utilization of prenatal care, increased prenatal testing rates, and decreases in perinatal HIV transmission. Conclusions: These case studies emphasize two key similarities among these programs: the value of collaboration between agencies providing care and services to HIV-infected and high-risk women of childbearing age, and the importance of maximizing opportunities for HIV testing and treatment. These strategies have demonstrated effectiveness in improving health outcomes and reducing perinatal HIV transmission.
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Notes
All statistical comparisons were performed using the Pearson chi-square test.
EPS data represent a subset of cases reported in HARS. Data collection associated with EPS is considerably more labor-intensive, and not all cases in the HARS data can be located for complete EPS follow up. However, EPS generally contains more reliable prenatal care detail.
Adequacy of prenatal care is measured by using the Kessner index, which combines information on the length of gestation, timing of the first prenatal care visit, and number of visits.
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ACKNOWLEDGMENTS
The authors would like to thank Jeffrey Wiener, Divisions of HIV/AIDS Prevention, CDS, for assistance with statistical tests.
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Clark, J., Sansom, S., Simpson, B.J. et al. Promising Strategies for Preventing Perinatal HIV Transmission: Model Programs from Three States. Matern Child Health J 10, 367–373 (2006). https://doi.org/10.1007/s10995-005-0047-x
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DOI: https://doi.org/10.1007/s10995-005-0047-x