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Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Index

A

Abortion, 17, 26, 45, 102-103, 269, 278, 324

Accountability

clinical policy performance measures, 18, 117-118, 125, 133, 196

health care plans/providers, general, 8, 62-63, 65, 89, 187

state programs, federally funding criteria, 1, 4-5, 10, 16-17, 57, 59, 61, 122-123, 125-126, 173, 175, 177, 181, 343-346

see also Cost and cost-benefit factors

ACTG (AIDS Clinical Trials Group)

ACTG 076 (AIDS Clinical Trials Group protocol number 076)34, 39,48, 120, 127, 359

awareness of, 75, 114

compliance with, 96, 107, 121-122, 208, 209, 243, 264

general, 49, 62

impact of, general, vii, 1, 4, 5, 14, 15-16, 68, 106, 128, 213, 331

Medicaid managed care, 66

rapid testing, 13, 52

steps involved in implementation, 206

unintended pregnancies, 12

see also ''counseling guidelines" and "testing guidelines" under Public Health Service

Adolescents, 103, 176, 180, 212, 242, 243-244

attitudes, 243-244

community-level services, 56, 62, 131-132, 156, 161, 243-244

injection drug users, 131, 244

Medicaid, 131, 244

rapid tests, 13, 130

testing of, 13, 117, 130, 131-132, 243-244

see also School-based programs

Advocacy, vii, 34, 314, 336

AFP, see Alpha-fetoprotein

African Americans

patient vignettes, 246-247

prenatal care trends, 74

prevalence, 3, 38, 40-41, 204, 228, 357

sickle cell disease, 19, 25, 27-28

testing of newborns, 333

testing of women, 34-35, 74, 87, 89, 93, 95, 207, 226, 288, 290,293, 296, 298, 300, 302

Age factors

AIDS development in infants/children, 37, 205

epidemiology, 39, 41, 53, 321

incarcerated women, 129

polymerase chain reaction tests, 52

service provision, 214

testing of women, 87, 207, 289, 290, 293, 297, 299, 300

ZDV use, 238

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

AIDS Drug Assistance Program, 175, 238

AIDS Education and Training Centers, 196, 211

AIDS exceptionalism, 32, 33, 314

AIDS Health Education Centers, 7, 114

AIDS Policy Center for Children, Youth and Families, 73, 230-231

AIDS Public Information Data Set, 37

AIDS service organizations, 57, 157, 169

Aid to Families with Dependent Children, reform of, 63, 184

see also Temporary Assistance for Needy Families

Alabama, 19, 86-87, 100, 231, 252-259

Alaska, 86-87

Alcohol use and abuse

Medicaid coverage of abusers, 172

prenatal care use and, 231

testing of newborns, 30

testing of women, 30, 277

treatment for, 180

see also Substance abusers

Alpha-fetoprotein, 25-26, 29, 193

American Academy of Family Physicians, 72, 214-216

American Academy of Pediatrics, 1, 25, 27, 72, 193-194, 331

American Association of Health Plans, 221-222

American College of Nurse Midwives, 73, 219-220

American College of Obstetricians and Gynecologists, 1, 25, 29, 71 -72, 166, 167, 192-193

American Medical Association, 72-73, 191-192

Americans with Disabilities Act, 155, 187, 195

Association of Maternal and Child Health Programs, 220-221

Association of Women's Health, Obstetric, and Neonatal Nurses, 216 -218

Attitudes

family members, 239, 240-241, 247, 248, 257, 269, 277

patients, 21, 81, 101, 120, 213, 231, 232

adolescents, 243-244

drug treatment, acceptance/refusal, 241, 243, 246-247, 248, 256-257, 261, 278, 284

immigrants, 244, 245

individuals, accounts of, 232-234, 246-248, 266-269, 275-285

testing, acceptance/refusal, 5, 6, 14, 18-19, 21, 31, 71, 72, 77, 85, 86-89, 92-96, 105, 111, 120, 121-122, 133, 191, 207, 212, 222, 231, 233, 277, 363

ZDV treatment acceptance/compliance, 96-100, 213, 229, 256, 261, 268, 276-277, 279, 283, 284, 307, 309

providers, 21, 32, 75, 76-85, 198-199, 209, 233-234, 242, 281, 282 , 283-284

counseling, 32, 75, 76-85, 117, 193, 200, 206, 213, 226, 237, 239, 242, 243, 281

sexual behavior, discomfort with discussing, 242, 243, 281

stigma and taboo, 2, 6, 7, 14, 21, 28-29, 31, 32, 33, 112-113, 231 , 239, 268, 317

see also Cultural factors;

Religious factors

AZT, see Zidovudine

B

Balanced Budget Act of 1997, 64, 65, 169, 185

Behavioral interventions, see Counseling;

Psychotherapy

Behavioral Risk Factor Surveillance System, 85, 88-89, 94

Birth control, see Abortion;

Contraception;

Family planning

Block grants, 177, 180

Maternal and Child Health Services Block Grant, 158, 161, 177-178, 184, 218, 220-221

Prevention and Treatment of Substance Abuse Block Grant, 180

primary care, federal requirements, 57, 165, 177, 257-258

Substance Abuse, Prevention, and Treatment Block Grant, 57, 164-165

TANF, 63

Blood donation and transfusion, 31, 40, 89, 268, 287, 317

hemophilia/coagulation disorders, 40, 176, 262

Bragdon v. Abbott, 58

Breast-feeding, 13, 17, 45, 46, 53, 72, 73, 102, 130, 161, 162, 190 , 194, 197-200 (passim), 213-214, 219, 240, 248, 261, 266, 278, 314 , 359, 365

counseling, 4, 52, 199-200, 213

WIC program, 104, 233, 261, 282

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Bureau of HIV/AIDS, 11

Bureau of Primary Health Care, 60, 160, 174, 178

C

California

counseling and testing, 70, 75, 80-83, 86-87, 89-90, 114, 116, 216 -219, 336

prevalence, 25, 43, 204, 205

ZDV use, 94-95

California Perinatal HIV Testing Project, 218-219

Canada, 111

Case finding, 22, 23, 249

Case management, 124, 160, 175, 179, 212, 262, 263, 272

ZDV use, 97, 212

Center for Substance Abuse Treatment, 165, 180

Centers for Disease Control and Prevention (CDC), 19, 42, 178-180, 206

community-based care, 162-163, 169

counseling, 62, 74, 75-77, 80-81, 84, 176, 179, 181, 210, 342, 343

drug treatment/testing, 49

prenatal care trends, 74-75

primary and specialty care, 60, 62

reporting, 37-38, 344, 357

sexually transmitted disease clinics, 162-163

state programs and, 4-5, 37, 165-166, 169, 181, 197, 314, 320-321, 324, 325

testing of newborns, 315

testing of women, 74, 75-77, 80-81, 84-88, 94-96, 130, 179, 342,343

ZDV use studies, 97

see also Public Health Service;

other subordinate organizations

Cesarean sections, 51, 103, 233, 279

Child Health Insurance Program, 59, 132, 173-174

Children with Special Health Care Needs, 177

Chlorhexidine, 51

Chorioamnionitis, 46, 47, 51

Clinical policy performance measures, 18, 117-118, 125, 133, 196

Clinical practice guidelines, 8, 14, 18, 19, 49(n), 72, 75, 84-85, 115-117, 218, 225, 238, 254, 263, 279

see also "counseling guidelines" and "testing guidelines" under Public Health Service

Colorado, 75, 78-79, 84

Community-based health services, 60-61, 155-170, 175, 253, 262

adolescents, 56, 62, 131-132, 156, 161, 243-244

contracted, 159-160

counseling, 157-171 (passim), 176-179 (passim), 181

family planning clinics, 55, 56, 92-93, 127, 160-161, 253

home care, 61, 157, 169-170, 173, 175, 212, 238, 258

list of providers, 157

local health departments, 157-158

Maternal and Child Health Services Block Grant, 158, 161, 177-178, 184, 211, 218, 220-221

Medicaid, 155, 156, 159, 160, 165

Ryan White CARE Act of 1990, 160, 165

Ryan White CARE Act Programs, 169, 176

school-based programs, 56, 61, 62, 163-164, 180

screening and testing, general, 56-57, 155, 157, 160

state programs, 158, 159, 162, 164-165, 165-166

STD services, 56, 131, 162-163, 255-256

testing of women, 155, 157, 160-176 (passim), 179, 181

see also Outreach

Community Programs for Clinical Research on AIDS, see Terry Beirn Community Programs for Clinical Research on AIDS

Condoms, 266, 280, 281

Confidentiality and privacy, 314, 316, 322, 333

adolescents, 243

prison populations, 224

testing of women, 23, 32, 34, 35, 72, 73, 81, 83, 85, 120, 121, 122 , 194, 211, 213, 215, 217, 243, 246, 254, 256, 267, 360, 361

Connecticut, 42, 84-85, 88-89, 204

Consumer education, 176, 213, 230, 323

Consumer information program (HCFA), 230

Contraception, 12, 128, 161, 280

abortion, 17, 26, 45, 102-103, 269, 278, 324

condoms, 266, 280, 281

Hispanic culture, 266

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Contracts and contracting, 60-62, 119

community health centers, 159-160

Medicaid managed care, 8-9, 14, 18, 66, 118-119, 133, 169

primary and specialty health care, 56-57

prisons, health care services, 56-57, 164

Coordinated HIV Services and Access to Research for Children, Youth, Women, and Families, 176

Correctional institutions, 13, 20, 55, 56-57, 129-130, 164, 176, 223-224, 253, 262, 273, 277

age factors, 129

contracted services, 56-57, 164

Cost and cost-benefit factors, 5, 23

case finding, 23

cesarean sections, 103, 233

counseling, 6, 305, 306, 307

developing countries, viii

financial barriers to health care access, 5, 13, 63-65, 128, 243

managed care, 186

Medicaid, 185

prenatal care, general, 132, 304-307

testing of women, 6-7, 200, 306-307, 321

ELISA, 6-7, 112, 304-305, 307

general 23, 52, 81

home-based, 169

ZDV, 306

see also Accountability;

Funding

Counseling, 4, 12, 28, 32, 110-111, 181, 190, 207, 210, 231, 322-323, 332, 334

attitudes toward, providers, 32, 75, 76-85, 117, 193, 200, 206, 213, 226, 237, 239, 242, 243, 281

breast-feeding, 4, 52, 199-200, 213

WIC program, 104, 233, 261, 282

CDC sites, 62, 74, 75-77, 80-81, 84, 176, 179, 181, 210, 342, 343

community-based services, 157-171

(passim), 176-179

(passim), 181

cost factors, 6, 305, 306, 307

defined, 22, 24, 375

drug therapy, 49, 229, 241, 246, 247 ZDV therapy, risks of, 48-49, 219, 361

family members, 22, 217

family planning, 73, 127, 210, 253

follow-up testing and, 115, 361

funding, 10, 16, 62, 67, 123, 124, 161, 169, 176-179 (passim), 181 , 194, 196, 200, 210, 230, 237-238, 242, 249, 261, 265, 342, 343

gender factors, 260

genetic, 24-25, 28, 29, 193, 323

HCFA, 230

Hispanics, 245

HRSA sites, 62, 211, 212-213

inadequate/inappropriate, 101-103, 195, 199-200, 213, 218, 231, 248 , 264, 268, 281

managed care, non-Medicaid, 242

Medicaid managed care, 66, 67, 119, 196, 209, 210, 230

non-directive, 24-25, 219

nurses/nurse-midwives, 97, 117, 124, 167-168, 212, 216-217, 219, 271

peer, 19

PHS guidelines, vii, 1, 5, 15, 36, 38, 71-73, 104, 105, 106, 110-111, 114, 115, 166, 168, 171, 186, 190-198, 203, 206, 215-234 (passim), 237, 253-254, 263, 307, 357, 358-359, 360-361, 363-364, 365-366

physicians, 11, 67, 72, 101, 114, 117, 166-167, 193, 195, 197, 213, 215, 228, 239, 241-243, 249, 263, 273, 281, 324, 327, 333

political factors, vii, 322-323

post-test, 116, 120, 163, 165, 193, 213, 215, 249, 255, 334

inadequate/inappropriate, 101-103, 195, 199-200, 231, 264, 268, 281

preconception, 12, 127, 128, 217, 218, 280;

see also Family planning

prenatal care providers, 5, 71-73, 76-85, 107, 110, 117, 124, 192, 197-200, 201, 209, 210, 216, 217, 221, 226, 237, 239, 242, 246, 249, 253, 254-256, 258, 265, 271, 359

pre-test, 107, 110-112, 113, 116-117, 120, 163, 165, 170, 193, 199, 212, 215, 216, 223, 243, 249, 255, 272, 273, 283

professional education on, 71, 114, 116, 177, 218, 225, 249

professional organizations, policies, 7-8, 71-73, 113-115, 191-195, 214-223, 361

psychotherapy, 4, 52, 71, 121, 192-193, 217, 224

risk-based, 81, 83, 85, 114, 276

rural areas, 82-83

Ryan White CARE Act Amendments of 1996, 10, 16, 230, 342-344

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Ryan White CARE Act Programs, 124, 177, 195

school-based, 56, 61, 62, 163, 178, 180

social factors, general, 21, 23, 217

sickle cell disease, 28

site visits, 237-270

state programs/policies, 62, 71, 115, 165-166, 169, 176, 181, 195, 196, 218, 225-227, 232, 242, 253, 255, 257, 320, 322, 323, 324, 327, 329-332, 333, 334, 336

legislation, 1, 15, 66, 68, 69, 70, 74-75, 91, 106, 107, 108, 114, 196, 198, 210, 217, 218, 223, 227, 228, 232, 236, 239, 242, 265, 271

specific states, 69, 70, 74, 75, 80-84, 86-90, 114, 116, 124, 216-219, 271-273, 336;

see also "counseling and testing" under specific state names

telephone help lines, 70

time limitations, 5, 85, 193, 213, 217, 237, 238, 241, 242, 249, 263

managed care, 67, 241-242

universal/routine, 15, 32, 69, 71, 72, 73, 104, 106, 111-112, 168, 191-193, 203, 215, 219, 220, 221, 223, 229, 237, 249, 253, 255, 257 , 323, 324, 329-332, 333, 342-344

routine testing vs, 6, 8, 113, 115, 191, 192, 255

WIC program, 57, 104, 161-162, 233, 261, 282

see also Informed consent;

Partner notification;

Patient education;

Patient notification

CPCRA, see Terry Beirn Community Programs for Clinical Research on AIDS

Cultural factors, 5, 132, 214, 244, 249, 266

religious factors, 26, 121, 244, 255, 257-258, 269, 272, 284, 331

stigma and taboo, 2, 6, 7, 14, 21, 28-29, 31, 32, 33, 112-113, 231, 239, 268, 317

see also Language factors

D

Delaware, 80-81, 231

Demographic factors, general, 235, 286-303, 321

see also Age factors;

Gender factors;

Homeless persons;

Marriage and marital status;

Racial/ethnic factors;

Regional factors;

Rural areas;

State-level factors;

Urban areas

Dentists and dentistry, 61, 177, 178, 214, 262

Department of Agriculture, see Special Supplemental Nutrition Program for Women, Infants and Children

Department of Health and Human Services

see also specific agencies

Department of Justice, 165

Developing countries, viii

Diagnosis and diagnostic tools, 1, 45-46

heel-stick blood sampling, 27, 34, 38, 97, 203, 307, 319

home-based, 169-170

rapid tests, 13, 52, 130-131

see also Enzyme-linked immunosorbent assays;

Immunoassays;

Polymerase chain reaction tests;

Testing of newborns;

Testing of women;

Western blot tests

Discrimination

AIDS-related, 23, 31-34 (passim), 58, 69, 121, 191, 194, 207, 213, 248, 317, 360, 361

AIDS exceptionalism, 32, 33, 314

Americans with Disabilities Act, 155, 187, 195

employment, 28, 187, 211, 248, 360, 361

insurance, 58, 187, 195, 207, 345-346

newborns, treatment of, 198-199

racial, 2, 21

stigma and taboo, 2, 6, 7, 14, 21, 28-29, 31, 32, 33, 112-113, 231, 239, 268, 317

Diseases and disorders, other than HIV/AIDS

chorioamnionitis, 46, 47, 51

genetic, 24-25, 28, 29, 193, 323 sickle cell disease, 19, 25, 27-28

hemophilia/coagulation disorders, 40, 176, 262

hepatitis, 25, 111

neural tube defects, 26, 29-30

phenylketonuria, 25, 27, 33, 215

Pneumocystis carinii pneumonia, 4, 31, 34, 41-42, 53, 205, 222, 276, 314, 322, 325, 360

tuberculosis, 158, 165, 253, 265, 320

see also Screening and testing, general;

Sexually transmitted diseases, other than HIV/AIDS

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Disproportionate share hospitals, 65, 185, 194

District of Columbia, 42

Domestic violence, 69, 191, 211, 231, 233, 240-241, 245, 256, 273, 277

Drug abuse, see Substance abusers

Drug treatment for HIV/AIDS, 4, 216, 218, 258, 342, 365, 366

acceptance of, 241, 243, 246-247, 248, 256-257, 261, 278, 284

adolescents, 243

AIDS Drug Assistance Program, 175, 238

counseling, 49, 229, 241, 246, 247 risk of therapy, 48-49, 219, 361

Medicaid coverage, 59-60, 65, 172-173, 175, 238, 256

multiple drugs, 103, 164, 233-234, 256, 261, 280, 284

physician involvement, 261, 263, 264, 268

Pneumocystis carinii pneumonia, 4, 31, 34, 41-42, 53, 205, 222, 276, 314, 322, 325, 360

regional centers, 10-11, 123-125

risks of, 48, 49-50, 213, 219, 263, 360, 361

Ryan White CARE Act Amendments of 1996, 342

Ryan White CARE Act Programs, 175, 238, 257, 272

state coverage, 61-62, 175

see also ACTG 076;

Zidovudine

E

Eastern U.S.

prenatal care trends, 74

prevalence of HIV infection, 3, 7, 38, 39, 42, 112, 204

testing, 289, 291, 297, 299, 300

Economic factors, see Cost and cost-benefit factors;

Funding;

Poverty;

Socioeconomic status

Education, see Patient education;

Professional education;

Public education

Educational attainment

access to services, 156, 257

testing of women, 95, 207, 287, 288, 290, 293, 296, 298, 300, 302

ELISA, see Enzyme-linked immunosorbent assays

Emergency Relief Grant Program for Eligible Metropolitan Areas, 174 -175

Employment factors

insurance, 58

job discrimination, 28, 187, 211, 248, 360, 361

managed care, 65, 185

Medicaid eligibility and, 64, 128, 185

Enzyme-linked immunosorbent assays, 51-52, 102, 115, 240, 264, 361 , 364

cost of, 6-7, 112, 304-305, 307

predictive value, 305-306

Epidemiology

age factors, 39, 41, 53, 321

gender factors, 3

racial/ethnic factors, 3, 38, 40-41, 204, 228, 321

African Americans, 3, 38, 40-41, 204, 228, 357

Hispanics, 3, 38, 40-41, 204

regional, 3, 38-39, 42-44, 69, 112, 204

state-level, 42-43, 44, 69, 252-253

specific states, 7, 20, 25, 42-44, 112, 204, 205, 228, 236, 260, 263, 319-321;

see also "prevalence" under specific state names

trends in transmission, general, 1, 3, 15-16, 36, 38-44, 104, 204-206, 225, 357-358, 361

urban areas, 3, 38-39, 43-44, 236, 243, 358

see also Natural history of HIV/AIDS;

Surveillance;

Transmission factors

Ethical issues, 220, 256, 280

developing countries, viii

multiple drug therapies, 103, 256

named HIV reporting by states, viii, 315, 326-327, 335-336

sickle cell disease, 29

testing of women, vii, 17, 19, 23-24, 73, 220, 321

see also Confidentiality and privacy;

Informed consent

Etiology, see Natural history of HIV/AIDS;

Transmission factors

Europe, 39, 48

F

Family members, 176, 194, 220, 221, 231, 262

attitudes toward HIV-positive members, 239, 240-241, 247, 248, 257 , 269, 277

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

counseling, 22, 217

domestic violence, 69, 191, 211, 231, 233, 240-241, 245, 256, 273, 277

Hispanics, 244, 248, 266-267, 269

HIV-related medical services, 72, 323, 332

immigrants, 132, 265

see also Partner notification

Family planning

clinics, 55, 56, 92-93, 127, 160-161, 253

counseling, 73, 127, 210, 253

unintended pregnancies, viii, 12, 103, 127-128, 278

see also Contraception

Family practice practitioners, 56, 76-77, 156, 167, 193

American Academy of Family Physicians, guidelines, 72, 214-216

see also Pediatricians

Federal government, general, 4, 68, 125

see also Funding;

Legislation, federal;

specific departments and agencies

Federal Health Center programs, 178

Florida

counseling and testing, 80-81, 86-89, 124, 271-273

Medicaid contracts, 66

prevalence, 7, 42, 112, 204, 205

surveillance, 204

ZDV use, 98-99, 100

Food and Drug Administration, 51, 59, 130, 172, 240, 364

Foreign countries, see International perspectives

Foster care, 34, 71, 277, 281, 285, 325, 330-332, 345, 364

Funding, 4-5, 10, 57, 59-67, 121, 122-124, 155, 156, 170-188, 261-262, 283, 314

CDC state programs, 4-5, 37, 165-166, 169, 181, 197, 314, 320-321, 324, 325

Child Health Insurance Program, 59, 132, 173-174

community-based programs, 10, 56-57, 61-62, 155-169 (passim), 234, 324

counseling, 10, 16, 62, 67, 123, 124, 161, 169, 176-179 (passim), 181, 194, 196, 200, 210, 230, 237-238, 242, 249, 261, 265, 342, 343

disproportionate share hospitals, 65, 185, 194

drug treatment, 57, 256-257, 238, 256, 258, 262

AIDS Drug Assistance Program, 175, 238

Medicaid coverage, 59-60, 65, 172-173, 175, 238

HRSA projects, 5, 10, 11, 61, 123, 124, 174-178, 212-214, 261-262

local health departments, 157-158

outreach, 10, 62, 123, 158, 160, 176, 179, 181, 239, 342

phenylketonuria, 27

pregnant women, 55, 57

prenatal care, 10, 57, 122, 123, 124-125, 165, 177-178, 233, 239, 249, 265, 272

prevention, 10, 60, 62, 122, 180, 228, 234, 261, 262

primary care, 57, 60, 62, 165, 176, 177, 178, 238

research, 11, 122, 123, 124, 176-177, 237-238;

see also National Institutes of Health

Ryan White CARE Act of 1990, 1

Ryan White CARE Act Amendments of 1996, 1, 10, 123, 342-344, 346

Ryan White CARE Act Programs, 10, 123, 124, 174-177, 181, 195, 211 , 272

sickle cell disease, 28

specialty care, 57, 60-61, 62, 169, 279

state programs, federal funding criteria, 1, 4-5, 10, 16-17, 57,59, 61, 122-123, 125-126, 173, 175, 177, 181, 343-346

testing, general, 1, 16, 200, 210, 315, 342, 343

urban areas, 174-175

see also Block grants;

Contracts and contracting; Insurance;

Managed care;

Medicaid;

Ryan White CARE Act Programs

G

Gender factors

counseling, 260

domestic violence, 69, 191, 211, 231, 233, 240-241, 245, 256, 273, 277

epidemiology, 3

prevention, male role, 233, 281

service provision, general, 214, 231

sexually transmitted disease clinics, 162

testing, 2, 21, 220, 240-241

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Geographic factors, see Regional factors;

Rural areas;

State-level factors;

Urban areas

Georgetown Law Center, 19

Georgia, 75, 76-77, 86-87, 92-96

Government, see Federal government;

Local government;

State government

Grants, see Funding

Gynecologists, see Obstetricians/gynecologists

H

Hawaii, 76-77, 84, 86-87

Health Care Financing Administration (HCFA), 11, 124, 196, 218, 229 -230

Health care professionals, 56, 72, 254

adolescents' providers, 131

attitudes of, 21, 32, 75, 76-85, 198-199, 209, 233-234, 242, 281, 282, 283-284

counseling, 32, 75, 76-85, 117, 193, 200, 206, 213, 226, 237, 239, 242, 243, 281

testing and counseling, surveys, 76-85

see also Confidentiality and privacy;

Nurse midwives;

Nurse practitioners;

Physicians;

Prenatal care;

Professional education

Health care services, 4-5, 18, 54-67, 100-104, 128-129, 211-212

access to, 5, 9, 12-13, 14, 17, 56-57, 102, 212, 263-266, 273, 277 -279

correctional institutions, 13, 20, 55, 56-57, 129-130, 164, 176, 223-224, 253, 262, 273, 277

financial barriers, 5, 13, 63-65, 128, 243;

see also Uninsured persons;

Welfare reform

pregnancy as opportunity, viii

regional centers, 10-11

transportation assistance, 102, 121, 131, 160, 212, 214, 258, 264, 278, 282

availability of, general, 54, 72, 76-95

blood donation and transfusion, 31, 40, 89, 268, 287, 317

community-based, 12, 54, 56-57, 60-61, 155-189

coordination of, 9-10, 18, 62-63, 119-121, 124, 163, 179, 180, 196

dentists and dentistry, 61, 177, 178, 214, 262

families of HIV patients, 72, 323, 332

see also Drug treatment for HIV/AIDS;

Hospitals;

Insurance;

Managed care; Prenatal care;

Primary care providers;

Specialty care;

Testing of newborns;

Testing of women

Health Insurance Portability and Accountability Act, 58, 155, 187

Health maintenance organizations (HMOs), 197, 216, 218, 221-222,236(n), 261, 263, 278-279, 287

see also Kaiser Permanente Health Plan

Health Plan Employer Data and Information Set (HEDIS), 119, 217, 222-223

Health Resources and Services Administration (HRSA), 5, 60, 174-178, 211-214, 261-262

Maternal and Child Health Services Block Grant, 158, 161, 177-178, 220-221

professional education programs, 212-213, 214

regional centers, 11, 123

see also Ryan White CARE Act of 1990;

Ran White CARE Act Amendments of 1996;

specific bureaus

Healthy Start, 163, 211

Heel-stick blood sampling, 27, 34, 38, 97, 203, 307, 319

Hemophilia/coagulation disorders, 40, 176, 262

Hepatitis, 25, 111

Hispanics, 244-245, 248, 266

family factors, 244, 248, 266-267, 269

patient vignette, 247-248

prevalence, 3, 38, 40-41, 204

testing of women, 34, 87, 89, 207, 218, 226, 244-245, 266, 288, 290 , 293, 296, 298, 300, 302

Historical perspectives, 5, 17-18

diagnosis trends, 1

prenatal care trends, 74

screening and testing, general, 21, 25, 26-30, 31-32, 34, 190-191, 313-340

transmission trends, general, 1, 3, 7, 15-16, 36, 38-44, 104, 108, 204-206, 225, 357-358, 361

HIV Early Intervention Services, 176

HIV Programs for Children, Youth, Women and Families, 10-11, 123

Home care, 61, 157, 169-170, 173, 175, 212, 238, 258

testing, 169-170

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Homeless persons, 13, 55, 130, 131, 160, 176, 178, 179, 211, 243, 244, 263, 277, 319

Homosexuality, 31, 268, 316-317

advocacy, 34, 326

Hispanic culture, 266

sex with bisexual males, 40, 260

Hospitals, 55, 82-83, 92-95, 159, 262

disproportionate share hospitals, 65, 185, 194

Human rights, see Ethical issues

I

Idaho, 69

Illinois, 43, 94-95

Immigrants, 56, 103, 117, 130, 132, 240, 242, 244-245, 265-266, 272 , 317

patient education materials, 71, 218, 249

testing of women, 56, 63, 64, 103, 117, 128, 130, 132, 245

welfare/Medicaid reform, 63, 64, 128, 132, 172, 183, 184, 233, 244 , 245, 272

see also Hispanics

Immigration and Naturalization Service, 64, 184, 244, 283

Immunoassays, 51, 115

see also Diagnosis and diagnostic tools;

Enzyme-linked immunosorbent assays ;

Western blot tests

Income, see Poverty;

Socioeconomic status

Indiana, 70, 232

Informed consent, 23, 72, 73, 77, 81, 110, 111, 120, 193, 196, 254 , 271, 279, 321, 322-323, 334, 363, 364

adolescents, 243

rapid tests, 130, 240

refusal, documentation of, 24, 71, 97, 110, 193

Injection drug users, 3, 38, 39, 40, 99, 126-127, 204, 223-224, 239 , 241-242, 260, 273, 286-287, 292, 316, 317, 320, 335, 360, 361,363

adolescents, 131, 244

patient vignette, 246-247

rapid tests, 13

sex with, 3, 38, 39, 40, 126-127, 273

Insurance, 4, 54, 57-60, 128, 171-172, 187

accountability, 8, 62-63, 65, 89, 187

American Association of Health Plans, 221-222

community-based care, 160, 165

discrimination by insurers, 58, 187, 195, 207

Ryan White CARE Act Amendments of 1996, 11, 342, 345-346

employment-based, 58

Health Insurance Portability and Accountability Act, 58, 155, 187

immigrants, 245

PHS guidelines, 171

Social Security Disability Insurance, 60, 173

state law, discontinuation of coverage, 17, 345-346

universal testing, 7-8

see also Health maintenance organizations;

Managed care;

Medicaid;

Uninsured persons

International perspectives, 39, 111

J

Jails,

see also Correctional institutions

Joint Commission on Accreditation of Health Care Organizations, 196 , 217

K

Kaiser Permanente Health Plan, 86-87, 90-91, 116, 117, 152, 222

Kansas, 69

L

Language factors, 5, 244

Medicaid managed care contracts, 8-9, 14, 18, 66, 118-119, 133, 169

patient education materials, 71, 218, 249

Legal issues, 23, 85, 209

immigrants, 56, 103, 117, 130, 132, 240, 244-245, 248, 265-266, 272

welfare reform, 63, 64, 128, 233

litigation, 62, 210, 326, 336

insurance, discrimination, 58, 187, 195

malpractice, 6, 24, 29, 103, 111-112, 115, 195, 249, 336

undocumented persons, 13, 103, 184, 240, 244, 245, 263, 272

see also Confidentiality and privacy;

Discrimination;

Ethical issues;

Informed consent

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Legislation, federal, 5

Americans with Disabilities Act, 155, 187, 195

Balanced Budget Act of 1997, 64, 65, 169, 185

Health Insurance Portability and Accountability Act, 58, 155, 187

National Sickle Cell Anemia Control Act, 28

Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 63-64, 183, 184

Public Health Service Act, 161, 178

study at hand, mandate, vii, 17, 68, 346

see also Ryan White CARE Act of 1990;

Ryan White CARE Act Amendments of 1996;

Social Security Act

Legislation, state, 5, 19, 23, 231-232

counseling, 1, 15, 66, 68, 69, 70, 74-75, 91, 106, 107, 108, 114, 196, 198, 210, 217, 218, 223, 227, 228, 232, 236, 239, 242, 265,271

PCP prophylaxis, 34

reporting, 71, 215

substance abusers, 30, 31, 128-129, 209

testing, 1, 6, 15, 18, 25, 26, 27, 28, 30, 32, 34, 66, 68, 69, 83, 91, 114, 210, 218, 228, 254, 261, 264-265, 271, 282

mandatory newborn testing, viii, 19, 71, 195, 197-200, 232, 236, 245-246, 248, 313-340

Local factors, other, see Community-based factors

Local government, 5, 62, 183

health departments, 157-158

regional systems, 11, 124-125

surveillance, 37, 125

Louisiana

counseling and testing, 74, 82-83, 88-89

surveillance, 204

ZDV use, 98-99

Low-income status, see Poverty

M

Maine, 86-87

Malpractice, 6, 24, 29, 103, 111-112, 115, 195, 249, 336

Managed care, 56, 63, 65-66, 67, 176, 185-186, 209, 218, 220, 221-223, 241-242

community-based services, 155, 156, 159, 168-169

cost factors, 106

counseling, non-Medicaid, 242

discrimination, 58

employment-based, 65, 185

hospitals, 159

Medicaid, 11, 14, 18, 60, 65-66, 104, 155, 156, 159, 168-169, 172-173, 185, 186, 210, 230, 262, 336

contracts, 8-9, 14, 18, 66, 118-119, 133, 169

counseling, 66, 67, 119, 196, 209, 210, 230

specialty care, 65, 66, 104, 262

state role, 65-66, 119, 185, 195

patient notification and followup, 102

poor persons, access to non-Medicaid services, 186

regional systems, 11, 124-125

uninsured persons, 66

see also Health maintenance organizations

Marriage and marital status

marriage licenses, 27, 28, 248

testing of women, 28, 286, 288, 290, 296, 298, 300

see also Domestic violence;

Partner notification

Maryland, 27, 42-43, 204, 205

Massachusetts, 80-81, 116, 221, 225-226, 318

Mass media, 121, 225, 321, 326, 330, 331, 332, 333-334

Maternal and Child Health Bureau, 11, 60, 177-178

Maternal and Child Health Services Block Grant, 158, 161, 177-178, 184, 211, 218, 220-221

Maternal serum alpha-fetoprotein, 25-26, 29

see also alpha-fetoprotein

Medicaid, 4, 59-60, 104, 120, 172-173, 184-185, 238, 336

adolescents, 131, 244

Child Health Insurance Program, 59, 132, 173-174

community-based services, 155, 156, 159, 160, 165

employment and eligibility, 64, 128, 185

performance measures and, 118

prenatal care trends, 74

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

reform of, 63-65, 128, 183-185

Balanced Budget Act of 1997, 64, 65, 169, 185

managed care, 11, 14, 18, 60, 65-66, 104, 155, 156, 159, 168-169, 172-173, 185, 186, 210, 230, 262, 336

contract language, 8-9, 14, 18, 66, 118-119, 133, 169

counseling, 66, 67, 119, 196, 209, 210, 230

specialty care, 65, 66, 104, 262

state role, 65-66, 119, 185, 195

regional centers, 11, 124

state role, 59-60, 63-64, 104, 128, 172-174, 185

managed care, 65-66, 119, 185, 195

testing of women, 87, 95, 207

Medicare, 118, 159, 173

Membrane ruptures, 47, 51, 72, 194, 279

Mental health care, 160, 163, 176-177

psychotherapy for HIV-positive patients, 4, 52, 71, 121, 192-193, 217, 224

substance abuse treatment, 4, 51, 55, 57, 127, 128-129, 160, 164-165, 172, 180, 184

Michigan

counseling and testing, 69, 74, 75, 78-79, 84, 86-89

surveillance, 204

ZDV use, 97, 98-99

Midwest U.S., 39, 204, 289, 291, 297, 299, 300

Midwives, see Nurse midwives

Migrant workers, 56, 160, 176, 178, 211, 262, 265

Minnesota

counseling and testing, 82-83, 84

ZDV use, 98-99

Minority groups, see Racial/ethnic factors

Mississippi, 69

Missouri, 82-83

Montana, 75, 80-81

N

National Ambulatory Medical Care Survey, 167

National Cancer Institute, 233

National Committee for Quality Assurance, 8-9, 217, 222-223

National Health Interview Survey, 90-91

National Institute of Allergy and Infectious Diseases, 182

National Institute of Child Health and Human Development, 181-182

National Institute of Justice, 224

National Institutes of Health, 181-182

primary and specialty care, 62

regional centers, 11, 124

sickle cell disease, 28

see also ACTG

National Medical Association, 72, 194, 244

National Sickle Cell Anemia Control Act, 28

National Survey of Childbearing Women, 357-358

National Survey of Family Growth, 90-91, 286-303

Natural history of HIV/AIDS, 4, 22, 45-47

AIDS development in infants/children, 37, 205

testing and, 2, 11, 30-31

Neural tube defects, 26, 29-30

Nevada, 84-85, 98-99

New Jersey

counseling and testing, 19, 25, 70, 74, 75, 76-77, 80-81, 88-89,114, 227-229

prevalence, 7, 43-44, 112, 204, 205, 228, 236

site visit summary, 236-251

surveillance, 204

ZDV use, 97, 98-101, 228-229

New York City, 212

adolescents, 131

counseling and testing, 19, 34, 88-89, 92-93, 236-251

prevalence, 43-44, 236

site visit summary, 236-251

ZDV use, 97-100

New York State

counseling and testing, 70, 86-87, 88-89, 231, 236-251

mandatory newborn testing, viii, 19, 71, 195, 197-200, 232, 236, 245-246, 248, 313-340

partner notification, 32

prevalence, 42, 112, 204, 205, 319-321

sickle cell disease, 28

universal testing, 7

ZDV use, 97, 98-99, 100

North Carolina, 226-227

counseling and testing, 75, 82-83, 88-89, 90-93, 226-227

surveillance, 204

ZDV use, 100-101

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Northeastern U.S.

prenatal care trends, 74

prevalence of HIV infection, 3, 7, 38, 39, 42, 112, 204

testing, 289, 291, 297, 299, 300

Notification, see Partner notification;

Patient notification

Nurse midwives, 76-77, 82-83, 167-168, 193, 219-220

American College of Nurse Midwives, 73, 219-220

Association of Women's Health, Obstetric, and Neonatal Nurses, 216 -218

Nurse practitioners, 55, 56, 76-77, 82-83, 117, 124, 168, 216-218, 263

ZDV use, 97

Nutrition, 47, 56

WIC, 57, 104, 162-163, 233, 261, 282

see also Breast-feeding

O

Obstetricians/gynecologists, 76-85, 156, 160, 166, 212, 215, 242, 262-263

American College of Obstetricians and Gynecologists, 1, 25, 29, 71 -72, 166, 167, 192-193

Office of Population Affairs, 60, 160

Ohio, 78-79

Oklahoma, 86-87

Oregon

counseling and testing, 75, 76-77, 84

ZDV use, 98-99

Outreach, 9, 160, 161, 230, 263

adolescents and their providers, 131, 243

funding, 10, 62, 123, 158, 160, 176, 179, 181, 239, 342

site visit summaries, 237, 257

see also Case management; Public education

P

Partner notification, 12, 31, 32, 35, 71, 170, 179, 193, 197, 215, 240, 326-327, 335-336

domestic violence and, 69, 191, 211, 231, 233

physician's involvement, 235, 322, 335

Patient education, 110, 116-117, 120

AMA guidelines, 72

community-based services, 160

foreign language, 71

state programs, 70, 71, 254, 265

telephone help lines, 70

WIC breast-feeding guidelines, 104, 233, 261, 282

ZDV use/risk factors, 48-49, 50, 96, 97, 100, 101, 210, 213, 219, 230, 233

see also Counseling

Patient notification, 6-9, 14, 16, 24-25, 109-113, 133, 215, 264, 269, 334, 345

inappropriate practices, 101-102, 231, 264, 268, 281

see also Partner notification

Pediatric AIDS Clinical Trials Groups, 62;

see also ACTG

Pediatricians, 56, 166-167, 212, 215

American Academy of Pediatrics, 1, 25, 27, 72, 166-167, 193-194,331

Pediatric Spectrum of Disease, 204, 208

Pennsylvania, 205

Performance measures, see Clinical policy performance measures

Perinatal Guidelines Evaluation Project, 204, 207, 211

Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 63-64, 183, 184

Pharmacological agents, see Drug treatment for HIV/AIDS

Phenylketonuria, 25, 27, 33, 215

Physicians, general, 55, 56

American Medical Association, 72-73, 191-192

counseling by, 11, 67, 72, 101, 114, 117, 166-167, 193, 195, 197, 213, 215, 228, 229, 232, 239, 241-243, 249, 263, 273, 281, 320, 324 , 327, 333

sexual behavior, discomfort with discussing, 242, 243, 281

time limitations, 5, 241, 270

discrimination by, 199

drug therapy, 261, 263, 264, 268

malpractice, 6, 24, 29, 103, 111-112, 115, 195, 210, 249, 336

Medicaid payment, 59

partner notification by, 235, 322, 335

testing by, 26, 56, 70, 76-85, 111-112, 113, 114, 194-195, 215, 216 -217, 228,

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

229, 232, 255, 262, 264, 273, 320, 326, 327, 333, 334, 335

see also Family practice practitioners;

Obstetricians/gynecologists;

Pediatricians;

Primary care providers

Placental risk factors, 46, 53

Planned Parenthood, 56, 161

Pneumocystis carinii pneumonia, 4, 31, 34, 41-42, 53, 205, 222, 276 , 314, 322, 325, 360

Political factors, 209, 283

agency ''turf wars,"; 221, 224

testing, 23, 34, 279, 312-340

see also Advocacy

Polymerase chain reaction tests, 46, 52-53, 200, 278, 334, 362, 364

Poverty, 260

AIDS as a cause of, 184

health care access, 5, 56, 156

community-based, 156, 160, 161, 162

managed care, not Medicaid, 186

pregnancy as factor, viii

testing, 2, 34, 91, 261, 289, 291, 293, 297, 299, 300

see also Medicaid;

Welfare reform

Pregnancy Risk Assessment Monitoring System, 94-95, 204, 206, 207

Prenatal care

access to/awareness of, general, 2, 5, 12-13, 18-19, 67, 73-85, 107 , 128, 133, 158, 206-210, 231, 239, 240, 253, 255, 276, 282, 283, 304-312, 363

educational attainment, 156, 257

family attitudes, 257

immigrants, 132, 233, 244-245, 265-266, 269, 272, 283

incarcerated women, 13, 20, 55, 56-57, 129-130, 164, 176, 223-224, 253, 262, 273, 277

racial/ethnic factors, 74, 206

rural areas, 253, 255

substance abusers, 107, 108, 128-129, 131, 206-207, 208-210, 231, 239, 277, 282

cost factors, 132, 304-307

counseling during, 5, 71-73, 76-85, 107, 110, 117, 124, 192, 197-200, 201, 209, 210, 216, 217, 221, 226, 237, 239, 242, 246, 249, 253, 254-256, 258, 265, 271, 359

cultural barriers, 5, 67

education of providers, 7-8, 113-115, 133

funding, 10, 57, 122, 123, 124-125, 165, 177-178, 233, 239, 249,265, 272

HIV patient treatment, 119, 120, 124, 128, 129, 216

regional centers, 10-11, 123-124

ZDV use, 5, 9, 40, 48-49, 68, 69, 97-106, 107, 109, 120-121, 126, 164, 208-209, 210, 212, 213, 277, 284, 356, 357, 362, 365

nurses, 167

see also Community-based health services;

Screening and testing, general;

Testing of women

Prevention and Treatment of Substance Abuse Block Grant, 180

Primary care providers, 102, 120-122

adolescents, 56

Bureau of Primary Health Care, 60, 160, 174, 178

community-based services, 159, 160, 163, 165, 221

condoms, 266, 280, 281

contracting for, 60, 165

coordination with HIV services, 11, 120-122, 123, 211-212, 216, 221 , 257-258

correctional facilities, 56-57

funding, 57, 60, 62, 165, 176, 177, 178, 238

HIV centers/specialists as, 104, 263

low-incidence areas, 102

model for HIV services, 127, 225

policy control, 62

professionals, provider types, 166-170

regional centers, relations with, 11, 123

rural areas, 121, 257-258

Ryan White CARE Act Programs, 62, 107

state programs, 57, 60-61, 62, 165, 177, 257-258

Primary prevention, general, vii-viii, 12, 19, 64, 126-127, 321-322

correctional facilities, 14, 129

defined, 126

funding, 10, 60, 62, 122, 180, 228, 234, 261, 262

HEDIS, 222, 223

male role, 233, 281

Pneumocystis carinii pneumonia, 4, 31, 34, 41-42, 53, 205, 222, 276 , 314, 322, 325, 360

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

regional centers, 10-11, 123-125

Ryan White CARE Act Programs, 62, 107

unintended pregnancies, viii, 12, 103, 127-128, 278

welfare reform, 184

see also Breast-feeding;

Counseling;

Prenatal care;

Screening and testing, general;

Testing of newborns;

Testing of women

Prisons, see Correctional institutions

Privacy, see Confidentiality and privacy

Private-sector role, 5

community-based services, 56, 156, 157, 160

pharmaceutical companies, 49

see also Contracts and contracting;

Insurance;

Managed care

Professional education, 18, 28, 72, 75, 116, 120, 176, 209, 249,263, 282-283

clinical practice guidelines, 8, 14, 18, 19, 49(n), 72, 75, 84-85, 115-117, 218, 225, 238, 254, 263, 279

counseling, 71, 114, 116, 177, 218, 225, 249

HRSA projects, 212-213, 214

state programs, 70, 71, 255

universal testing and, 7-8, 14, 113-115, 191-195, 196

Professional organizations, 1, 62-63, 68, 71, 114

counseling and testing policies, 7-8, 14, 71-73, 113-115, 191-195, 196, 214-223, 361

see also specific organizations

Psychotherapy, 4, 52, 71, 121, 192-193, 217, 224

Public assistance, see Medicaid;

Welfare reform

Public education, 9, 13, 28, 62, 117, 128, 212, 257, 316

community-based, 161

mass media, 225

national, 112-113, 230

state programs, 61, 70, 117

see also Outreach;

Patient education

Public health issues, general, vii, 17

see also Screening and testing, general

Public Health Service, 349-371

clinical practice guidelines, 8, 14, 75, 84-85

counseling guidelines, vii, 1, 5, 15, 36, 38, 104, 105, 106, 110-111, 114, 115, 166, 171, 190-191, 195-197, 206, 215-234 (passim), 237, 253-254, 263, 307, 357, 358-359, 360-361, 363-364, 365-366

Florida Conference, 271-273

site visits, 239-270 (passim)

state role, 1, 6, 69-71, 74-96, 108, 114, 195-197

testing guidelines, 8, 14, 18, 36, 48, 51, 68-71, 73-108 (passim), 166, 190, 195-197, 203-234 (passim), 307, 357, 358-366

ZDV, 96-106 (passim), 107, 190, 196, 206, 208, 209, 230, 264

Public Health Service Act, 161, 178

Puerto Rico, 204, 205

R

Racial/ethnic factors, 17-18

access to services, 156

epidemiology, 3, 40-41

National Medical Association, 72, 194, 244

prenatal care trends, 74, 206

prevalence, 3, 38, 40-41, 204, 228, 321

sickle cell disease, 28-29, 207

testing of women, 2, 21, 28, 34-35, 74, 87, 89, 93, 95, 207, 226, 288, 290, 293, 296, 298, 300, 302

ZDV use, 97

see also African Americans;

Hispanics;

Immigrants;

White persons

Regional factors

prevalence, 3, 7, 38-39, 42-44, 69, 112, 204

prevention and treatment centers, 10-11, 123-125

state role, 11, 124-125

testing, 7, 10-11, 112, 114, 123-124, 289, 291, 297, 299, 300

see also specific regions

Religious factors, 26, 121, 244, 255, 257-258, 269, 272, 284, 331

Reporting, 215

Centers for Disease Control, 37-38, 344, 357

prenatal care professionals, 75

rapid tests, 13, 130-131

state systems, 71, 215, 254

named HIV reporting, viii, 315, 326-327, 335-336

Research

funding, general, 11, 122, 123, 124, 176-177, 237-238

HIV patient, opinion, 280

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

New York City metropolitan area, 237-238

regional centers, 11, 123

Ryan White CARE Act Amendments of 1996, 343-344, 346

Ryan White CARE Act Programs, 181

study at hand, methodology, vii-ix, 19-20, 304-312

testing, 31, 74-96, 90-91, 286-303

ZDV use, 48-49, 97-101, 210

see also ACTG;

National Institutes of Health;

Surveillance

Rhode Island, 70, 80-81

State prison system, 129-130, 223-224

Risk factors, general, 209

counseling, risk-based, 81, 83, 85, 114, 215, 276

drug therapy, risks involved, 48-49, 50, 122

ZDV, 48-49, 50, 96, 97, 100, 101, 210, 213, 219, 230, 233

education regarding, 71, 249

hemophilia/coagulation disorders, 40, 176, 262

immigrants, 245

placental, 46, 53

testing, risk-based, 32-33, 81, 83, 85, 114, 276, 286-287, 292, 294 , 303

see Breast-feeding;

Injection drug users;

Primary prevention;

Sexual behavior;

Sexually transmitted diseases, other than HIV/AIDS;

Transmission factors

Rural areas, 176, 211, 212, 253, 258, 358

counseling and testing, 82-83

migrant workers, 56, 160, 176, 178, 211, 262, 265

primary care, 121, 257-258

sickle cell disease, 28

Ryan White CARE Act of 1990

community-based services, 160, 165

funding, 1

Ryan White CARE Act Amendments of 1996, 341-346

counseling, 10, 16, 230, 342-344

drug treatment, 342

excerpts from legislation, 341-346

funding, 1, 10, 123, 342-344, 346

insurance coverage discrimination, 342-344, 346

overview, viii, 1-2, 16-17

partner notification, 197

patient notification, 16, 345

research, 342-344. 246

surveillance, 125, 343-344, 346

testing,

newborn testing, mandatory, viii, 16, 33-34, 123, 174, 345, 346

women, 10, 16, 123, 174, 230, 342-346

Ryan White CARE Act Programs

adolescents, 176

case management, nurses, 124, 272

community-based services, 169, 176

counseling, 124, 177, 195

funding, 123, 124, 174-177, 181, 195, 211, 272

insurance coverage uninsured/underinsured, 175

primary and specialty care, 61, 107

drug treatment, 175, 238, 257, 272

prisons, 176, 224

research, 181

special needs population, 176-177, 211, 262

testing, women, 124, 195, 230, 272

urban areas, 174-175

S

School-based programs, 56, 61, 62, 163-164, 180

Screening and testing, general, 2-3, 8, 14, 21-30, 36, 62, 178, 316 -324

community-based programs, 56-57, 155, 157, 160

genetic, 24-25, 28, 29, 193, 323

historic perspectives, 21, 25, 26-30, 31-32, 34, 190-191, 313-340

pregnancy testing, 161;

see also Testing of women

principles of, 22-24

screening, defined, 22, 24-25, 375

completely mandatory, 24

conditionally mandatory, 24

non-directive patient choice, 24

routine with notification, 6, 24

routine without notification, 24

substance abuse, testing for, 30, 49

newborns, 30, 165, 277

testing, defined, 22, 375

see also Case finding;

Confidentiality and privacy;

Patient notification;

Testing of newborns

Sex-based influences, see Gender factors

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Sexual behavior, 38, 40, 204, 209, 260, 280, 292, 295, 324, 360,361, 363

Hispanic culture, 266

immigrants, taboos, 245

injection drug users, sex with, 3, 38, 39, 40, 126-127, 273

physicians' discomfort with discussing, 242, 243, 281

see also Homosexuality

Sexually transmitted diseases, other than HIV/AIDS, 120, 179-180, 292, 294

community-level services, 56, 131, 162-163, 255-256

primary prevention, 12

syphilis, 21, 25, 26, 35, 111, 257

testing, 25, 26, 257

see also Syphilis

Sickle cell disease, 19, 25, 27-28

Social factors, 186, 209

counseling and testing, 21, 23, 217

stigma and taboo, 2, 6, 7, 14, 21, 28-29, 31, 32, 33, 112-113, 231 , 239, 268, 317

see also Cultural factors;

Political factors;

Racial/ethnic factors

Social Security, 173

Social Security Act, 172

Child Health Insurance Program, 59, 132, 173-174

Maternal and Child Health Services Block Grant, 158, 177-178, 184, 211, 218, 220-221

see also Medicaid;

Supplemental Security Income

Social Security Disability Insurance, 60, 173

Social workers, 163, 237, 263, 282, 326

Socioeconomic status

access to services, 156

see also Poverty

South Carolina

counseling and testing, 74, 76-77, 84, 86-89, 232, 289, 291

surveillance, 204

ZDV use, 98-99

Southern U.S., 3, 7, 39, 112, 204, 289, 291, 297, 299, 300

Special Projects of National Significance, 176-177, 211, 262

Special Supplemental Nutrition Program for Women, Infants and Children (WIC), 57, 161-162

breast-feeding guidelines, 104, 233, 261, 282

Specialty care, general, 57, 100, 102, 120, 159, 221-222, 225, 278 -279

centers for specialized HIV care, 10-11, 100, 101-104, 123-125, 255

children, 56, 262

funding, 57, 60-61, 62, 169, 279

linkage/access to, 9, 65, 119, 120-121, 124, 186, 193, 209-210, 218, 220-222, 272, 334

Medicaid managed care, 65, 66, 104, 262

professionals, provider types, 166-170

Ryan White CARE Act Programs, 62, 107

state programs, 57, 60-61, 62, 165, 177, 257-258

see also Drug treatment for HIV/AIDS;

Family practice practitioners;

Nurse midwives;

Nurse practitioners;

Obstetricians/gynecologists;

Pediatricians

SSI, see Supplemental Security Income

SSI Disabled Children's Program, 60, 64

State-Enhanced Pediatric HIV Surveillance Program, 74, 88-89, 204, 206, 207

State government, 2, 5, 18, 19, 32, 68, 180-181, 183

CDC programs, 4-5, 37, 165-166, 169, 181, 197, 314, 320-321, 324, 325

community-based programs, 158, 159, 162, 164-165, 165-166

federal funding criteria, 1, 4-5, 10, 16-17, 57, 59, 61, 122-123, 125-126, 173, 175, 177, 181, 343-346

Medicaid, 59-60, 63-64, 104, 128, 172-174, 185

managed care, 65-66, 119, 185, 195

primary and specialty care, 57, 60-61, 62, 165, 177, 257-258

professional education programs, 70, 71, 255

regional systems, 11, 124-125

reporting, 71, 215, 254

named HIV reporting, viii, 315, 326-327, 335-336

surveillance, 37, 38, 74, 88-89, 125, 204, 206, 207, 231, 318-319

testing

mandatory, viii, 19, 71, 195, 197-200, 232, 236, 245-246, 248, 313 -340 (passim)

newborns, 25, 30, 34, 38, 69, 195-197

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

PHS counseling/testing guidelines, 1, 6, 69-71, 74-96, 108, 114, 195-197

programs, other, 68, 232, 313-340

Ryan White CARE Act of 1990, 16

Ryan White CARE Act

Amendments of 1996, viii, 16, 33-34, 123, 345, 346

Ryan White CARE Act Programs, 174

See also New York State

universal, viii, 7-8, 16, 19, 71, 123, 195

women, 25, 26, 27, 28, 30, 69-71, 74-96, 108, 114, 195-197, 225-229

correctional institutions, 13, 20, 55, 56-57, 129-130, 164

legislation, 1, 6, 15, 18, 25, 26, 27, 28, 30, 32, 34, 66, 68, 69, 83, 91, 114, 210, 218, 228, 254, 261, 264-265, 271, 282

programs, other, 5, 68, 165-166, 216-217, 218, 223-229, 324

Ryan White CARE Act

Amendments of 1996, 10, 16, 123, 230, 342-346

Ryan White CARE Act Programs, 124, 174, 195, 272

substance abusers, 30, 31, 128-129

ZDV guidelines/use, 94-95, 97-101, 114, 196, 228-229

see also Funding;

Legislation, state;

specific states

State-level factors, vii

counseling, survey of providers, 75, 76-85

managed care, 185

PHS counseling/testing guidelines, implementation, 1, 6, 69-71, 74 -96, 116

PHS ZDV guidelines, implementation, 97-101

prenatal care trends, 74-85

prevalence trends, 42-43, 44, 69, 252-253

ZDV use, 94-95, 97-101, 114, 196, 228-229

see also specific states

Stigma and taboo, 2, 6, 7, 14, 21, 28-29, 31, 32, 33, 112-113, 231 , 239, 268, 317

Substance Abuse and Mental Health Services Administration (SAMHSA) , 60, 165, 177, 180

Substance Abuse, Prevention, and Treatment Block Grant, 57, 164-165

Substance abusers, vii, 3, 103, 184, 224

Hispanic culture, 266

prenatal care, use by, 107, 108, 128-129, 131, 206-207, 208-210,231, 239, 277, 282

state law, 30, 31, 128-129, 209

testing,

HIV, 30, 31, 128-129, 210, 248, 324

rapid tests, 13, 131

testing for substance abuse, 30, 49

newborns, 30, 165, 277

treatment programs, 4, 51, 55, 57, 127, 128-129, 160, 164-165, 172 , 180, 184

see also Injection drug users

Supplemental Security Income, 60, 63-65, 183

Surveillance, 11, 33, 98-99, 196, 203-211, 342

data on, 36-38, 125-126

defined, 22

named HIV reporting, viii, 315, 326-327, 335-336

newborns, 37, 333

Pregnancy Risk Assessment Monitoring System, 94-95, 204

Ryan White CARE Act Amendments of 1996, 125, 343-344, 346

state-level, 37, 38, 74, 88-89, 125, 204, 206, 207, 231, 318-319

see also Reporting;

Testing of newborns;

Testing of women

Surveillance to Evaluate Prevention, 98-99, 206, 208, 228-229

Survey of Childbearing Women, 37, 125, 208, 228

Syphilis, 21, 25, 26, 35, 111, 257

T

Telephone help lines, 70

Temporary Assistance for Needy Families, 63-64, 183

Tennessee, 69, 70

Terry Beirn Community Programs for Clinical Research on AIDS, 62

Testing, general, see Screening and testing, general

Testing of newborns, vii, 4, 17, 19, 31, 33-34

African Americans, 333

alcohol/substance abuse, 30

foster care, 34, 71, 285, 325, 330-332, 345, 364

heel-stick blood sampling, 27, 34, 38, 97, 203, 307, 319

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

mandatory, 25, 71, 72-73, 191-192, 195, 233, 248, 272

funding contingent on, 10, 16, 123, 342-344, 346

Ryan White CARE Act Amendments of 1996, viii, 16, 33-34, 123, 174, 345, 346

see also New York State

patient vignettes, 247

phenylketonuria, 25, 27, 33, 215

PHS/professional organization guidelines, 68, 71-73, 193

professional education on, 7-8, 14, 113-115, 191-195, 196

rapid tests, 13, 52, 130-131

screening, defined, 22, 24-25, 375

completely mandatory, 24

conditionally mandatory, 24

non-directive patient choice, 24

routine with notification, 6, 24

routine without notification, 24

state government, 25, 30, 34, 38, 69, 195-197

mandatory, viii, 19, 71, 195, 197-200, 232, 236, 245-246, 248, 313 -340 (passim)

programs, other, 68, 232, 313-340

Ryan White CARE Act of 1990, viii, 16, 33-34, 123, 174, 345, 346, 357, 361, 363

substance abuse, 30, 165, 277

universal, 72, 109, 342-346 (passim)

urban areas, 315-316

voluntary, 27, 72, 123, 272, 330, 332, 342-346 (passim), 357, 361, 363

see also Diagnosis and diagnostic tools;

Screening and testing, "screening, defined"

Testing of women, vii, 2-3, 5-6, 17, 19, 21-35, 67, 68-108, 176

acceptance/refusal of, by women, 5, 6, 14, 18-19, 21, 31, 71, 72, 77, 85, 86-89, 92-96, 105, 111, 120, 121-122, 133, 191, 207, 212, 222, 231, 233, 277, 363

documentation of refusal, 24, 71, 97, 110, 193

educational attainment and, 95, 207, 287, 288, 290, 293, 296, 298, 300, 302

informed consent, 23, 72, 73, 77, 81, 110, 111, 120, 130, 191, 193 , 196, 240, 243, 254, 267-268, 271, 279, 321, 322-323, 334, 363,364

adolescents, 243

rapid tests, 130, 240

refusal, documentation of, 24, 71, 97, 110, 193

patient vignettes, 247

site visits, 237-239, 254, 255

adolescents, 13, 130, 131-132, 117, 243-244

age factors, 87, 207, 289, 290, 293, 297, 299, 300

community-based services, 155, 157, 160-176 (passim), 179, 181

coordination of, 9-10, 18, 62-63, 119-121, 124, 131-133

confidentiality, 23, 32, 34, 35, 72, 73, 81, 83, 85, 120, 121, 122 , 194, 211, 213, 215, 217, 243, 246, 254, 256, 267, 360, 361

correctional institutions, 13, 20, 55, 56-57, 129-130, 164, 176, 223-224, 253, 262, 273, 277

ethical issues, general, vii, 17, 19, 23-24, 73, 220, 321;

see also Confidentiality and privacy;

Informed consent

financial incentives for individuals, 257

gender factors, 2, 21, 220, 240-241

home-based, 169-170

immigrants, 56, 63, 64, 103, 117, 128, 130, 132, 245

intrapartum, 13, 17, 130, 240, 249

mandatory, 24, 25, 71, 72-73, 111, 113, 125, 191-192, 226, 276-277, 306

definitional issues, 24-25

marital status and, 28, 286, 288, 290, 296, 298, 300

Medicaid, 87, 95, 207

National Survey of Family Growth, 90-91, 286-303

PHS/professional organization guidelines, 1, 68-108 (passim), 190-197, 206, 215-234 (passim)

physician involvement, 26, 56, 70, 76-85, 111-112, 113, 114, 194-195, 215, 216-217, 228, 229, 232, 255, 262, 264, 273, 320, 326, 327, 333 , 334, 335

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

political factors, vii

predictive value, 305-306

professional education on, 7-8, 14, 113-115, 191-195, 196, 214-223, 361

professional organizations, 71-73, 113-115, 191-195, 214-223, 361

racial/ethnic factors, 2, 21, 28, 34-35, 74, 87, 89, 93, 95, 207, 226, 288, 290, 293, 296, 298, 300, 302

African Americans, 34-35, 74, 87, 89, 93, 95, 207, 226, 288, 290, 293, 296, 298, 300, 302

Hispanics, 34, 87, 89, 207, 218, 226, 244-245, 266, 288, 290, 293, 296, 298, 300, 302

rapid tests, 13, 52, 130-131, 239, 240, 249, 315;

see also "intrapartum" supra

regional centers, 10-11, 123-124

regional factors, 7, 10-11, 112, 114, 123-124, 289, 291, 297, 299, 300

risk-based, 32-33, 81, 83, 85, 114, 276, 286-287, 292, 294, 303

Ryan White CARE Act Amendments of 1996, 10, 16, 123, 230, 342-346

Ryan White CARE Act Programs, 124, 174, 195, 272

screening, defined, 22, 24-25, 375

completely mandatory, 24

conditionally mandatory, 24

non-directive patient choice, 24

routine with notification, 6, 24

routine without notification, 24

sexually transmitted diseases, not HIV/AIDS, 25, 26, 257

state government, 25, 26, 27, 28, 30, 69-71, 74-96, 108, 114, 195-197, 225-229

correctional institutions, 13, 20, 55, 56-57, 129-130, 164

legislation, 1, 6, 15, 18, 25, 26, 27, 28, 30, 32, 34, 66, 68, 69, 83, 91, 114, 210, 218, 228, 254, 261, 264-265, 271, 282

programs, other, 5, 68, 165-166, 216-217, 218, 223-229, 324

Ryan White CARE Act of 1990, 195

Ryan White CARE Act Amendments of 1996, 10, 16, 123, 174, 230, 342 -346

Ryan White CARE Act Programs, 124, 272

substance abusers, 30, 31, 128-129

stigma associated with testing per se, 32, 33, 255-256

substance abusers,

HIV testing, 30, 31, 128-129, 210, 248, 324

rapid tests, 13, 131

testing for substance abuse, 30, 49

universal and/or routine, 6-9, 14, 24-25, 79, 109-122, 125, 133, 190-193, 233, 255, 257, 275, 279, 281, 306-307

clinical practice guidelines, 8, 14, 18, 19, 49(n), 72, 75, 84-85, 115-117, 218, 225, 238, 254, 263, 279

see also "counseling guidelines" and "testing guidelines" under Public Health Service

urban areas, 74, 76-77, 80-81, 82-83, 88-91, 92-95, 291, 293, 297, 300

voluntary, vii, 1, 15, 24-26, 69-70, 71, 72, 73, 93-96, 111, 190-191, 193, 215, 217, 219, 233, 247, 255, 257, 276-277, 279, 287, 293, 306 , 324, 342, 343, 357, 361, 363;

see also "acceptance/refusal" supra

see also Counseling;

Diagnosis and diagnostic tools;

Partner notification;

Patient notification

Texas

counseling and testing, 69, 70, 74, 86-87, 260-270

prevalence, 20, 25, 43, 204, 205, 260, 263

South Texas site visit summary, 260-270

ZDV use, 98-99, 100

Therapeutic services, vii

see also Drug treatment for HIV/AIDS;

Health care services

Time factors

counseling, 5, 85, 193, 213, 217, 237, 238, 241, 263, 270

managed care, 67, 241-242

patient notification, 101

rapid tests, 13, 52, 130-131, 239, 240, 249, 315

Transfusions, see Blood donation and transfusion

Transmission factors, 18, 45-47, 307-312, 344, 357

advanced maternal HIV, 46-47, 48

age of infants and children, 37, 205

antepartum, 4, 45-46, 49, 53, 196, 358

placental, 46, 53

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

chain of, 2, 17

correctional settings, 13

current approaches to reduction, 17

descriptive epidemiology, 36-44

intrapartum, 4, 45, 46-47, 51, 53, 196, 358

cesarean sections, 51, 103, 233, 279

invasive procedures, 47, 51, 72, 73, 104, 233, 279

membrane ruptures, 47, 51, 72, 194, 279

rapid testing, 13, 130

ZDV use, vii, 1, 4, 15, 48, 96, 98, 99, 100, 208, 239, 278

postpartum, 4, 13, 46-47, 49, 196, 208, 358;

see also Breast-feeding

professional awareness of, 75

testing and screening, general, 2-3, 82, 310-311, 314

trends in transmission, general, 1, 3, 15-16, 36, 38-44, 104, 204-206, 225, 357-358, 361

see also Breast-feeding;

Epidemiology;

Risk factors;

Sexual behavior;

Substance abusers;

Surveillance

Transportation assistance, 102, 121, 131, 160, 212, 214, 258, 264, 278, 282

Treatment, see Drug treatment for HIV/AIDS;

Health care services

Tuberculosis, 158, 165, 253, 265, 320

U

Undocumented persons, 13, 103, 184, 240, 244, 245, 263, 272

Uninsured persons, 4, 56, 57, 64, 66, 170-171

AIDS discrimination, 58, 187, 195, 207, 345

community-based care, 156, 159, 161

disproportionate share hospitals, 65, 185, 194

managed care, 66

Ryan White CARE Act Amendments of 1996, 342, 345-346

Ryan White CARE Act Programs, 175

Unintended pregnancies, viii, 12, 103, 127-128, 278

United Kingdom, 111

Urban areas, 19-20, 123

adolescents, 243-244

funding, 174-175

prevalence of AIDS, 3, 38-39, 43-44, 236, 243, 358

Ryan White CARE Act Programs, 174-175

sickle cell disease, 28

testing of newborns, 315-316

testing of women, 74, 76-77, 80-81, 82-83, 88-91, 92-95, 291, 293, 297, 300

ZDV use, 98-99, 100

see also New York City

V

Vermont, 69

Violence, see Domestic violence

Virginia, 76-77, 84

W

Washington, 86-87

Welfare reform, 4, 63-65, 128, 182-184, 210

AFDC, 63, 184

Balanced Budget Act of 1997, 64, 65, 169, 185

community-based services, 155, 169

Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 63-64, 183, 184

TANF, 63-64, 183

see also Medicaid;

Special Supplemental Nutrition Program for Women, Infants and Children

Western blot tests, 51, 52, 115, 264, 306, 362

Western U.S., 39, 204, 289, 291, 297, 299, 300

West Virginia, 86-87

White persons, 38, 41, 47, 74, 288, 290, 296, 298, 300, 302

WIC, see Special Supplemental Nutrition Program for Women, Infants and Children

Wisconsin, 75, 78-79, 84

Women Organized to Respond to Life-threatening Diseases, 101

Women's Initiative for HIV Care and Reduction of Perinatal Transmission , 176, 211, 213

Z

Zidovudine (ZDV), vii, 1, 4, 15, 31, 48-49, 68, 72, 119, 176, 229, 230, 315

acceptance/refusal of treatment, 96-100,

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

213, 229, 256, 261, 268, 276-277, 279, 283, 284, 307, 309

compliance with regime, 96, 107, 121-122, 208, 209, 243, 264, 269, 307, 309

adolescents, 243

age factors, other, 238

case management, 97, 212

cost factors, 306

HRSA, 212, 213

infants, 47-49, 72, 176, 253, 359

intrapartum administration, vii, 1, 4, 15, 48, 96, 98, 99, 100, 208 , 239, 278

Medicaid coverage, 172-173

patient education, 48-49, 50, 96, 97, 100, 101, 210, 213, 219, 230 , 233

PHS guidelines, 96-106 (passim), 107, 190, 196, 206, 208, 209, 230 , 264

physician knowledge of, 264

prenatal use, 5, 9, 40, 48-49, 68, 69, 97-106, 107, 109, 120-121, 126, 164, 208-209, 210, 212, 213, 277, 284, 356, 357, 362, 365

prisoners, 164

research, 48-49, 97-101, 210

risks of use (side effects), 48-49, 50, 96, 97, 100, 101, 210, 213 , 219, 230, 233

state guidelines, 97-101, 114, 196

urban areas, 98-99, 100

women with HIV-infected partners, 280

see also ACTG 076

Suggested Citation:"Index." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Page 397
Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States Get This Book
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Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS.

Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January

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