The UTMB Maternal-Child HIV Program
The Maternal-Child Program is run by the Division of Pediatric Infectious Diseases/HIV in collaboration with the Department of Obstetrics and Gynecology, and the Adult HIV Program at UTMB.
The program provides HIV diagnostic and therapeutic services to HIV-positive pregnant women, HIV-exposed infants, and HIV-infected children, adolescents and youth.
The program is a major resource for the management of HIV-infected mothers and their children in the rural southeast Texas communities. The program has (i) developed a consensus protocols for management of pregnant women and their newborns to provide comprehensive care in order to reduce perinatal HIV transmission, and (ii) facilitated HIV care of women after delivery by coordinating appointments with the adult HIV clinics.
Comprehensive diagnostic and therapeutic services are provided at the Maternal-Child HIV twice weekly: Monday and Thursday, 9:30 - 12:30 AM, and at other times when necessary. All children delivered at UTMB are seen at birth. Subsequent visits are every two months till the diagnosis of HIV infection is determined. Infected children are followed every 2-3 months, or as often as necessary, until adulthood. All HIV-infected children receive neurodevelopmental assessment. Laboratory services include CD4 and HIV viral load determination. Clinical consultations with other pediatric specialists at UTMB are obtained as needed. Inpatient care is provided at the Children’s Hospital at UTMB whenever necessary. The site has multiethnic and multilingual staff.
Specific services for HIV-positive pregnant women: The pediatric HIV specialists of the program consult with all HIV-infected pregnant women several times during pregnancy, providing counseling, psychosocial evaluation, initiation of preventive antiviral treatment, monitoring HIV disease state, and coordination of other essential medical and social services. The obstetric specialists also see these women several times during pregnancy for comprehensive prenatal care, deliveries and postnatal care. A residential facility for pregnant women is available for those who need to stay overnight for outpatient services. Women who have planned to deliver at UTMB are admitted to the residential facility after 36 weeks of gestation at no cost to them.
The UTMB Regional Maternal and Child Health Program (RMCHP) provides prenatal care, primary and preventive child health care, family planning, dysplasia, and case management services to women and children in 50 southeast Texas counties, with 18 base sites and 24 satellite sites. Clinic services include high and low risk prenatal care, family planning, dysplasia, cancer stop, primary and preventive child health care for children ages birth to 21 years, immunizations, WIC, STD testing and treatment, and HIV counseling and testing. Case management services are provided for maternity and child health patients. It is estimated that 8,407 children ages 0 to 21 were served in FY 1999. Women’s health services will be available to an estimated 19,568 women across the life span. Clients are given individual appointments with a specific provider. In most clinics, Clinical Care Teams composed of a Provider, Nurse and Aide see each patient.
Outreach/Linkages with HIV Service Organizations
Community-Based HIV Service Organizations: The Maternal-Child HIV Program at UTMB interacts with several community-based service organizations to coordinate local care and improve access to UTMB-based care. Three primary organizations that have collaborative services with UTMB are: (I) AIDS Coalition of Coastal Texas, Inc, based in Galveston, serving Galveston, Brazoria and south Harris counties; (ii) Triangle AIDS Network Inc, based in Beaumont, serving Jefferson, Orange, Chambers and Hardin counties; (iii) Health Horizons of East Texas, formerly known as East Texas AIDS Project, based in Nacogdoches, serving Angelina, Houston, Nacogdoches, Polk, Sabine, San Augustine, San Jacinto, Shelby, Tyler, Trinity, Jasper and Newton counties. These agencies provide a variety of services: case management, emergency financial assistance, transportation, workshops, grief counseling, HIV testing, food pantry, prescription assistance, etc. These organizations have been the key allies of the UTMB HIV programs. Letters of collaboration are attached herewith.
Other agencies: The program interacts with AIDS Alliance of the Bay Area, Valley AIDS Council, and Gulf Coast Recovery Program. Furthermore, coordination of home services is handled through many home health agencies. Referrals are also made to the Family Services Centers’ Rural Outreach and Case Management Programs. AIDS Foundation Houston also has provided help for Christmas toys and arrangement for camps for HIV-affected or infected children.