90 Minute Workshop

Category: Care & Services

Presentation Date & Time: 03/25/98 15:45:00

The Helena Hatch Special Care Center is a one-stop model health care program for women with HIV situated at the Washington University School of Medicine in St. Louis. Its doors opened in January 1995 as the result of a five-year Health Resources and Services Administration (HRSA) Special Projects of National Significance (SPNS) cooperative agreement award. The model incorporates primary and specialty care into one setting, including state-of-art HIV care, OB/GYN services, Ryan White case management, patient education, nutritional consultation, ophthalmic screening, spiritual care, support groups, and psychological therapy. Concurrent pediatric HIV care is offered for the mothers' convenience, as well as on-site childcare, meals, and transportation. Between January 1995 and August 1997, client enrollment increased from 25 to 241 (864%), and as a result, the Center became the primary provider for women with HIV in the metropolitan area. Enrollees are predominately African-American (77%), young adults (50% in the 20-29 year age group), unemployed (73%), unmarried (77%), in the heterosexual HIV risk category (85%), % > high school graduate (65%), and with minor children (55%). Preliminary findings show 80 to 98% positive patient satisfaction ratings, an average of 75% clinic show rates, and 57.03 to 77.69 mean levels of health and functioning. Eighty percent within childbearing ages are on a reliable form of contraception but 44% have had at least one STD since enrollment. Preliminary outcomes of this program show a reduction of HIV vertical transmission from 44.4% in 1994 to 0% from 1/96 through 8/97; an increase in use of PCP prophylaxis from 78% in 1996 to 93% in 1997 in those with a CD4 count of <200 cells/mm3, an increase in use of antiretroviral therapy from 72% to 75% during the same time period in those with a median CD4 count of <500 cells/mm3, and a reduction in the annual mortality rate from 15.5% in 1995 to .006 in 1996 and 1997. Our future plans are to increase steps to promote therapeutic adherence, study the trends in hospitalization and ER visits, and estimate the costs of services versus overall outcomes.