Sunday, Sep 26 - Expo Hall Opening
Sunday, Sep 26 - Job Fair
Monday,
Sep 27 - AWHONN's Block Party
Monday, September 27, 2010
: 1:30 PM
Title: Partnering for Success: Collaborations for Linking HIV-Positive Pregnant Women to Care
Venetian
Discipline: Newborn (NB), Childbearing (CB)
Learning Objectives:
Submission Description:- Describe the key medical components of preventing mother-to-child transmission of HIV.
- Explain the legal context, perinatal HIV program activities, and perinatal nursing network structure in the state of Illinois.
- Define the value of collaboration and understand the elements required for linking hard-to-reach HIV-positive women to care.
HIV-infected pregnant women often experience fear and anxiety about the HIV-status of their exposed babies. Yet, research has shown that with proper treatment during pregnancy, labor and delivery, and the newborn period, HIV-exposed infants have a less than 2% chance of contracting the disease (Connor et al., 1994; Perinatal HIV Guidelines Working Group, 2009). Knowledge of HIV status and early entry into specialized HIV/obstetrical care are essential. Women with HIV at particularly high risk for perinatal transmission often face a complex set of socioeconomic factors (often including poverty, violence, substance use, homelessness, and denial of HIV status) that impede compliance with prenatal care and medical adherence (Lindau et al., 2006). As a result, adequate medical care for these cases requires a multidisciplinary approach that encompasses the obstetric, infectious disease, and social service needs of the patient.
The State ofIllinois has a unique partnership of programs aimed at identifying, supporting and linking to care HIV-infected pregnant women. These include a 24/7 Perinatal HIV Hotline and an intensive case management program aimed at this high-risk population. Additionally, state law requires counseling and the offering of a rapid HIV test to any woman who presents to a labor and delivery unit with an undocumented HIV status. The law also mandates rapid HIV testing for any newborn whose mother's HIV status was undocumented at the time of delivery (“Illinois Perinatal HIV Prevention Act,” 2006). All positive rapid HIV tests must be reported to the state's Perinatal HIV Hotline to ensure appropriate medical intervention and linkage to care. Illinois also has a unique perinatal program structure in which all hospitals – birthing and non-birthing - belong to one of 10 Perinatal Networks throughout the state. This structure allows for statewide communication regarding perinatal issues, policy and education.
This case presentation will illustrate the invaluable role the Perinatal Network structure and rapid HIV test reporting system/Perinatal HIV Hotline played in tracking and linking to care a patient with a highly complex medical and social situation. This pregnant and HIV-positive client was admitted to a number of institutions in an urban area of the state over the course of a few weeks, each time leaving against medical advice. The Perinatal Network structure was utilized as a means to alert area hospitals of this client and her unique medical situation and to encourage institutions to call the Hotline for assistance in her care. As a result of the cross-discipline (nurses, physicians, case managers, social workers, network administrators, and hotline staff) and cross-institutional collaboration that took place, the patient was successfully linked to care both for prenatal and postpartum care. Mother and infant are healthy and moving forward with their lives thanks to the dedication and tireless work of a diverse team working together to address and support the patient's challenging medical and social service needs.
The State of
This case presentation will illustrate the invaluable role the Perinatal Network structure and rapid HIV test reporting system/Perinatal HIV Hotline played in tracking and linking to care a patient with a highly complex medical and social situation. This pregnant and HIV-positive client was admitted to a number of institutions in an urban area of the state over the course of a few weeks, each time leaving against medical advice. The Perinatal Network structure was utilized as a means to alert area hospitals of this client and her unique medical situation and to encourage institutions to call the Hotline for assistance in her care. As a result of the cross-discipline (nurses, physicians, case managers, social workers, network administrators, and hotline staff) and cross-institutional collaboration that took place, the patient was successfully linked to care both for prenatal and postpartum care. Mother and infant are healthy and moving forward with their lives thanks to the dedication and tireless work of a diverse team working together to address and support the patient's challenging medical and social service needs.
