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Reducing the Odds Preventing Perinatal Transmission of HIV in the United States (1999) / Chapter Skim
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F Alabama Site Visit Summary
Pages 252-259

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From page 252...
... Alabama was chosen for a site visit because it is a southern state with a large rural population, and, as such, represents the region with the greatest recent increases in perinatal HIV transmission rates. Site visit discussions were held both in Birmingham (in Jefferson County)
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From page 253...
... These data are important in considering potential barriers to and solutions for improving perinatal HIV transmission rates. IMPLEMENTATION OF PHS GUIDELINES The site visit team sought information on the extent to which the July 1995 PHS recommendations for universal counseling and voluntary HIV testing of
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From page 254...
... was published, the state health officer and the state perinatal advisory committee sent out a joint letter to all health care providers in Alabama recommending that they follow the PHS recommended protocol. The ADPH has also incorporated PHS guidelines into guidelines for public health clinics throughout the state.
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From page 255...
... WARS offers a comprehensive prenatal care program that incorporates routine HIV/AIDS education/counseling and voluntary testing. Guideline Implementation and Test Acceptance Despite incorporation of guidelines at state and county levels and within some parts of the private sector, those interviewed were in agreement that provider implementation of HIV counseling and testing appears to be quite uneven in both the public and the private sectors, and that this variation is probably the most important factor in determining test acceptance.
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From page 256...
... To address variations in testing across sites, in November 1997 the health department held an in-service education program aimed at changing provider behavior. It is important to note that on an annual basis, clinics provide maternity care to about 5,000 pregnant women in Jefferson County, and to 30,000 women statewide (roughly half of all childbearing women in each jurisdiction)
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From page 257...
... Finally, one participant suggested that financial incentives or disincentives might prod providers to routinely include HIV testing. MODELS THAT WORK Throughout the site visit, participants provided examples of how innovative programs are successfully addressing perinatal HIV transmission.
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From page 258...
... Using a model developed under a Ford Foundation grant, program components include outreach and home visiting, the use of clearly laid out educational protocols, and monitoring of quality assurance. WARS achieves near universal prenatal testing among its maternity patients.
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From page 259...
... Goldenberg, MD, Professor and Chair, OB/GYN West Alabama Health Services P.O. Box 599 Eutaw, AL 35462 Sandral Hullett, MD, MPH, Director 259
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Key Terms

  • jefferson county
  • site visit
  • prenatal care
  • perinatal hiv
  • pregnant women

  • hiv transmission
  • hiv counseling
  • phs guidelines
  • phs recommendations
  • hiv testing

  • alabama health
  • routine testing
  • health officials
  • greene county
  • rural greene

  • west alabama
  • alabama department
  • officials noted
  • aids care
  • care program

  • health clinics
  • clinic sites
  • women tested
  • automated record
  • emotional support

  • comprehensive prenatal
  • test panel
  • hiv serology
  • provider implementation
  • clinics throughout


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