SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 3, Issue 3 (February 6, 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.

HIV continues to disproportionately affect poor women of color at alarming rates. Delivery of HIV-related services to women needs to be tailored, taking into consideration their complex needs and life demands. The Helena Hatch Special Care Center for Women with HIV (HHSCC) provides coordinated, comprehensive care designed to meet the unique needs of women living with HIV and their families in a pleasant, easily accessible and friendly environment. HHSCC targets women infected with HIV/AIDS in a 12-county region including and surrounding St. Louis, such as East St. Louis and the Missouri boot-heel.

HHSCC works with the community to identify gaps in outreach to women at risk, and to train providers regarding HIV counseling, testing, management, and issues related to perinatal transmission. The project ultimately aims to accomplish the following:

• Improve access to health care, clinical trials, and support services for women with HIV;

• Improve the quality of life and survival of women with HIV; and

• Maintain the dramatic decrease in the rate of HIV vertical transmission.

The HHSCC project offers one-stop primary and HIV medical services. Some of the multidimensional services also provided by HHSCC include outreach, patient education, support groups, retreat programs, case management, concurrent pediatric HIV care, OB/GYN care, eye screenings, psychological and nutritional counseling, spiritual counseling, and resource coordination. Other program components include peer training and involvement, on- and off-site provider education, and a quarterly newsletter (Ribbons). Barriers to access have been addressed through the provision of transportation, childcare, and food during center activities, peer support, and intensive follow-up including home visits.

During the first three years, numerous accomplishments were made by the project. HHSCC has become the care provider for the vast majority of women with HIV (including those who are pregnant) in the Metropolitan St. Louis area. Since the implementation of the project, total client enrollment increased by more than 900% (from 25 to 257 women), vertical transmission decreased among pregnant women served by the project (from 44.4% in 1994 to 8.5% in 1995 to 0% in 1996; see chart on the right). There also has been a monthly follow-up clinic show rate of 69%. Additionally, 75% of enrollees with <500 CD4 cells/mm³ are on antiretroviral therapy, and 93% of those with <200 cells/mm³ are on PCP prophylaxis.

For the remaining two years of SPNS Program funding, staff of this project plan to: 1) increase focus on enhancing antiretroviral therapy acceptance and adherence; 2) continue promotion of enrollment of women in ACTG trials; 3) expand patient education programs; 4) work with Project ARK (AIDS/HIV Resources for Kids) to begin an adolescent outreach and services program; 5) study trends in hospitalization and emergency room admittance; 6) estimate costs of services; and 7) measure project outcomes.

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, Phone: 314.747.1026, e-mail: kmeredit@imgate.wustl.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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