SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 2, Issue 14 (July 11, 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.

State University of New York at Brooklyn's Maternal and Pediatric Services (MAPS) Program

Given the important findings of the ACTG 076 and the advances in combination antiretroviral therapy, pregnant women who have not yet been tested can be shown the benefits of early HIV testing, (i.e., a decrease in perinatal transmission), and of having disease prognosis monitored. Consequently, the Maternal and Pediatric Services (MAPS) Program of the State University of New York (SUNY) at Brooklyn provides women of reproductive age access to prenatal HIV counseling and voluntary testing as part of routine OB/GYN care, and HIV perinatal transmission prevention and treatment for women and their exposed and/or infected children. The target population for the MAPS project is women seeking prenatal care at three New York City hospitals, as well as those private obstetrical patients who are to deliver at two of the three hospitals. Women who receive prenatal care off-site at a private solo or group practice are targeted due to the fact that they have the least amount of access to HIV counseling and testing. The specific goals of the State University of New York’s MAPS program are three-pronged:

• to enhance the manner in which testing is offered to pregnant women so that more will agree to be tested prenatally;
  

• to ensure that women’s healthcare providers are aware of the need for testing and the recommendations about the use of zidovudine during the perinatal period; and
  

• to secure appropriate clinical services for all mother-child dyads identified.

MAPS provides training and technical assistance to those care providers who are trying to make a difference prior to the birth of an infected infant. The program continues to offer referral and consultation until outside service providers feel competent in providing comprehensive care and management of HIV and perinatal transmission in women. Additionally, program staff who are uniquely trained in areas of policy, counseling, and program development clarify and disseminate information to service providers on the New York State regulations around HIV testing and counseling of pregnant women and newborns.

MAPS uses an integrated service delivery model that reflects the potentially unique ways in which HIV disease may affect women and the structural and human resource peculiarities of each of the target sites: a teaching hospital, a large municipal hospital, and a community-based hospital. The three Brooklyn hospitals that participate in the MAPS Program are SUNY/Health Science Center at Brooklyn’s University Hospital (SUNY/UHB), Kings County Hospital Center (KCHC), and Lutheran Medical Center (LMC). The chart to the right illustrates improvements made during the first five quarters of the project in the percentage of clients receiving HIV counseling and testing in each of these three hospitals. "Before" refers to the percentage of clients that were receiving HIV counseling and testing before the MAPS Program began and "after" refers to the percentage that were receiving such after the first five quarters of the project’s funding cycle.

• SUNY/UHB increased 19% (from 62% to 81% of clients)
  

• KCHC increased 26% (from 65% to 91% of clients)
  

• LMC increased 3% (from 93% to 96% of clients)

 

The hallmark of the MAPS model is enhancement of HIV counseling and testing services for pregnant and nonpregnant women, through clinician involvement and provision of HIV-related gynecological care. This model is underway at an especially critical time in New York State. With new laws in place requiring mandatory testing of all newborns, MAPS’s effort to make voluntary HIV counseling and testing available to all pregnant women, both public and private patients, is more important than ever.

For more information contact the MAPS Program Coordinator, Catherine Rohweder, Coordinator, 450 Clarkson Avenue - Box #1240, Brooklyn, NY 11203; 718.270.1846 (phone), 718.270.4244 (fax), or email at crohweder@netmail.hscbklyn.edu.

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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