Conference Abstract

Wiping Out Vertical Transmission: Practical Application of ACTG 076 in Both Urban and Rural Settings

R Bathon & A Burgess

The rate of vertical transmission in women with HIV infection has drastically decreased with the implementation of AIDS Clinical Trial Group (ACTG) 076 using zidovudine (ZDV) during pregnancy, delivery and newborn administration. The issue facing health care providers is the practical application of this finding in communities that lack resources to address additional barriers outside of a clinical setting. The Helena Hatch Special Care Center (HHSCC) at Washington University School of Medicine is a Special Projects of National Significance funded program. HHSCC provides coordinated medical and psychosocial care, counseling and education for 40 percent of all known HIV-infected women in the St. Louis metropolitan area. In response to the 076 protocol, the HHSCC has developed guidelines to:

1. address and resolve barriers

2. measure compliance

3. enhance multidisciplinary care of the client

Results show that the rate of vertical transmission with the use of the ACTG 076 protocol and the BHSCC guidelines has been reduced from 44.4 percent in 1994 to 9 percent in 1995 since the development of these guidelines. Identifying client needs and barriers becomes the first priority to increase compliance in a population that traditionally does not seek health care. Resolving these barriers allows for increased focus on managing the well being of the client. The use of the ACTG 076 protocol and the HHSCC guidelines can be used as a model program in other areas of the country that serve women with HIV infection.

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