SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 2, Issue 9 (May 2, 1997)

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.

Washington University School of Medicine’s Helena Hatch Special Care Center for Women

The prevalence of HIV continues to increase in women at alarming rates, disproportionately affecting poor women of color. Delivery of HIV related services to women has been difficult and sub-optimal in traditional health care systems primarily because these systems are often confusing, impersonal, and male-focused. The Helena Hatch Special Care Center for Women (HHSCC) is a specialized medical care clinic housed in Washington University School of Medicine. The Center targets women infected with HIV, the majority of whom are African American, within a 12-county region including and surrounding St. Louis, Missouri.

The HHSCC is a "one-stop-shop" for HIV-positive women that provides comprehensive primary and specialty care to meet the unique needs of women living with HIV. The HHSCC works with the community to identify gaps in outreach to women at risk, and to train service providers regarding HIV counseling, testing, management, and issues related to perinatal transmission. The specific goals of this project are to:

• develop a combined women’s and infant’s practice to increase access to culturally-competent, coordinated care;

• conduct community outreach to provide training to enhance care for women with HIV and to reduce transmission of HIV to women and infants at risk; and

• increase client access to clinical trials.

 

A key feature of the project is the personalized care provided by staff and their accessibility to the families affected by HIV. Since the initiation of this project, client enrollment in the project increased from 25 in November 1994 to 215 as of April 1997 (a greater than 760 percent increase). Intensive networking between the Center and community organizations has influenced the significant number of referrals to the program in a short time. Moreover, the Center has been successful in creating a comprehensive center for women with HIV, coordinating women’s services with pediatric HIV operations to offer family-centered care.

The Center offers medical and OB/GYN care along with case management, patient education, support groups, family-planning services, psychological and nutritional counseling, ophthalmologic screening, radiology, and phlebotomy. Pediatric HIV cases are followed concurrently with mothers’ cases, thereby increasing the incentive for mothers to receive care. In order to eliminate barriers to accessing needed HIV/AIDS care, transportation, childcare, and food are all provided to women when they visit the Center. Case managers integrate psychosocial services, including referrals to CARE Act services and community resources such as substance abuse programs, housing, and legal services. Outreach to clients includes facilitating their entire spectrum of care with home visits for assessment, education, and tracking of those lost to follow-up.

Program staff provide education and training on issues related to women and HIV to service providers and health care workers, OB clinics, STD clinics, primary care doctors, obstetric and emergency room personnel. In addition, staff regularly train medical house staff who rotate for a month through the Center’s clinic, learning about the management of women with HIV, and provide preceptorships to social work students. This has proven to be very effective in increasing the level of HIV/AIDS knowledge of clinic staff members which, in turn, has resulted in improved service delivery to people living with HIV/AIDS.

The principal investigator for the Helena Hatch Special Care Center is Victoria J. Fraser, M.D. For more information, contact the project director, Karen Meredith, M.P.H., R.N., at the Helena Hatch Special Care Center for Women, Washington University School of Medicine, Infectious Diseases-Box 8051, 660 S. Euclid, St. Louis, MO 63110, 314.747.1026.

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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