SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 1, Issue 5 (June 15, 1996)

This document has been superceded by our Online Knowledge Base on Innovative Models of HIV/AIDS Care. Click here to access the Knowledge Base. Click here to access descriptions of 27 Innovative Models of HIV/AIDS Care and the lessons learned from these projects. SPNS/Fax was written, published, and distributed by fax by The Measurement Group between 1995 and 1998.

Information dissemination from 27 Innovative Models of HIV Care projects funded as Special Projects of National Significance by the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA).

Introduction

Welcome to SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements. In each issue of SPNS/Fax, we will highlight findings from the HRSA Special Projects of National Significance Program Cooperative Agreements. The projects have been funded to develop innovative models of HIV/AIDS care. SPNS/Fax reports are distributed every two weeks by fax machine to all subscribers. All issues of SPNS/Fax are also available at this Web site. Due to slight differences in the media, issues distributed by fax machine may appear slightly different from those posted on this Web site, but the content is identical.

Cook County Maternal and Child Health/HIV Integration Project

The Maternal and Child Health (MCH) /HIV Integration Project in Cook County, Illinois has three main goals: 1) to build a comprehensive system of HIV counseling and testing for women during the perinatal period; 2) to provide training to MCH and family planning service providers about prevention, early identification, and care for women with HIV and their infants; and 3) to establish linkages between perinatal care and Ryan White CARE Act agencies to ensure continuation of care for women with HIV and their families.

During the spring and summer of 1995, the project conducted a needs assessment survey in the six perinatal networks in Cook County. The survey included questions about current HIV counseling and testing practices, perinatal risk reduction through the use of zidovudine (ZDV, AZT) by the mother and newborn, and barriers to the implementation of the Centers for Disease Control and Prevention (CDC) counseling, testing, and perinatal ZDV guidelines. A total of 87 needs assessments were completed.

The survey questions on perinatal risk reduction activities in hospitals revealed that:

  • More than half of the institutions (55%) are not implementing the guidelines on the use of zidovudine with perinatal patients.

  • 72% of the institutions do not have protocols in place for perinatal ZDV use.

  • HIV testing was offered by half of the perinatal providers and 41% of the family planning providers.

  • Written informed consent for HIV testing was required by approximately 85% of both types of institutions.

  • Approximately 60% of these institutions offered pre-test counseling.

  • Over 90% of the institutions offered post-test counseling to women who tested positive, whereas only 61% of the perinatal providers and 67% of the family planning providers provided post-test counseling to women who tested negative.

  • Less than half (41%) of the surveyed institutions reported providing HIV testing for newborns, and only 40% of those who did also provided counseling.

The chart shows barriers to implementing a comprehensive HIV testing and counseling program as cited by the participating institutions. Most of these institutions serve populations which are largely ethnic-cultural minorities with public insurance, and many serve a female population with a higher than average risk for HIV.

Since the needs assessment was conducted, the project has been working to train providers and change counseling and testing practices. The MCH/HIV project has also developed a training manual on counseling and testing and care during pregnancy distributed under the auspices of the Illinois Department of Health.

For more information contact Mary Driscoll, M.P.H., Cook County Hospital, 1835 W. Harrison, Room 2204-2nd Floor, Main Bldg., Chicago, IL, 60612, or email at driscoll@hektoen.org.

SPNS/Fax is produced by The Measurement Group–PROTOTYPES Evaluation and Dissemination Center (EDC). Editorial comments should be made to The Measurement Group at 5811A Uplander Way, Culver City, California 90230, 310.216.1051, 310.670.7735 (fax).
 

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