Perinatal HIV Service Coordination: Closing Gaps in the HIV Care Continuum for Pregnant Women and Eliminating Perinatal HIV Transmission in the United States.

Eliminating perinatal transmission of HIV and improving the care of childbearing women living with HIV in the United States require public health and clinical leadership. The Comprehensive Care Workgroup of the Elimination of Perinatal HIV Transmission Stakeholders Group, sponsored by the Centers for Disease Control and Prevention, developed a concept of perinatal HIV service coordination (PHSC) and identified 6 core functions through (1) semistructured exploratory interviews with contacts in 11 state or city health departments from April 2011 through February 2012, (2) literature review and summary of data on gaps in services and outcomes, and (3) group meetings from August 2010 through June 2017. We discuss leadership strategies for implementing the core functions of PHSC: strategic planning, access to services, real-time case finding, care coordination, comprehensive care, and data and case reviews.

Integrating health and prevention services in syringe access programs: a strategy to address unmet needs in a high-risk population.

Injection drug users are at a high risk for a number of preventable diseases and complications of drug use. This article describes the implementation of a nurse-led health promotion and disease prevention program in New Jersey's syringe access programs. Initially designed to target women as part of a strategy to decrease missed opportunities for perinatal HIV prevention, the program expanded by integrating existing programs and funding streams available through the state health department.

An end to perinatal HIV: success in the US requires ongoing and innovative efforts that should expand globally.

The dramatic reduction of perinatally transmitted HIV in the United States has been a striking success story in the HIV epidemic. Routine HIV screening during pregnancy followed by appropriate therapy has been extremely effective. This paper puts forth three strategies needed to maintain these gains and reach the goal of eliminating perinatal HIV: standardize medical interventions and policy changes that support perinatal HIV reduction; institute HIV screening in routine preconception care to identify HIV infection in women before pregnancy; and critically focus attention and resources on primary prevention of HIV infection in women.

A faculty trainer model: increasing knowledge and changing practice to improve perinatal HIV prevention and care.

Although routine counseling and HIV testing of pregnant women is recommended, it is not yet universally offered. This paper reports on a project that trained health care providers from 2000 to 2002 using a faculty trainer (or train-the-trainer) model. The goals of the projects were to increase knowledge and change practice, increase HIV counseling and testing in prenatal care, and improve management of HIV in pregnant women.

Service needs of male caretakers of HIV-infected and affected children: policy and practice implications.

The number of male caretakers (biological fathers and other men) of HIV-infected and affected children is substantial and may increase in the US and elsewhere as more women become infected. Little information exists about the needs these men have for support services to help them better perform their parenting roles as male caretakers (MCs). This paper discusses the service needs of MCs at Ryan White CARE Act Title IV programs, the challenges providers at these programs face in serving MCs, and the strategies they have found effective in working with MCs.

Rapid diagnostic testing for HIV. Clinical implications.

There have been many advances in HIV counseling, testing, and referral over the past ten years. One of the most recent advances is the United States Food and Drug Administration's (FDA) approval of a rapid test. As a result of the availability of rapid diagnostic testing for HIV, practices regarding testing and counseling need to be updated, particularly in time-sensitive situations in which rapid results are crucial.

Rapid diagnostic testing for HIV. Clinical implications.

There have been many advances in HIV counseling, testing, and referral over the past ten years. One of the most recent advances is the United States Food and Drug Administration's (FDA) approval of a rapid test. As a result of the availability of rapid diagnostic testing for HIV, practices regarding testing and counseling need to be updated, particularly in time-sensitive situations in which rapid results are crucial.