Reducing the Odds Preventing Perinatal Transmission of HIV in the United States (1999) / Chapter Skim
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G South Texas Site Visit Summary
G South Texas Site Visit Summary
Pages 260-270
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From page 260... ...
Unlike the other sites, though, South Texas encountered additional barriers in providing care because of its vast area, low prevalence of HIV in women, and proximity to Mexico. DEMOGRAPHICS OF HIV IN SOUTH TEXAS Geographically, South Texas is a large yet sparsely populated area that includes 54,000 square miles (about the size of New York State)
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From page 261... ...
Additionally, the Texas State legislature passed a law in February 1996 requiring routine HIV testing with notification of all pregnant women at the first prenatal visit and during delivery, except for those who specifically opt out. Since 1995, the number of children diagnosed with AIDS has dropped.
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From page 262... ...
The program has provided an array of services, including medical services, case managers, referrals to dental services, and transportation to help people keep their medical appointments. Case managers assist families so that children reach appointments on time.
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From page 263... ...
BARRIERS TO CARE Some of the barriers to implementing the PHS counseling and testing guidelines in South Texas are: counseling and informing patients in a low prevalence area, obtaining and correctly analyzing test results, notifying patients of the test results, the distance some must travel to obtain care, providing care for undocumented residents, and cultural stigma. The low prevalence of HIV in the South Texas region makes it difficult to educate physicians to counsel and inform their patients of HIV.
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From page 264... ...
In a number of cases, women with a positive ELISA and indeterminate Western blot were incorrectly informed that they were HIV-positive. Although all were eventually retested, this lack of attention to important facts about HIV testing may result in the patients' mistrust of their care providers and may contribute undue stress in the women's lives.
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From page 265... ...
Special Populations Undocumented Women Because of Texas' close proximity of the Mexican border, many Mexican women cross the border to deliver their babies in South Texas. Many of these women have not received prenatal care because they are ineligible for Medicaid.
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From page 266... ...
Upon receiving the positive test result from her provider, who is a medical resident, Theresa at first did not believe it. She asked questions about HIV, the medication, its side effects and potential harm to the baby, yet the resident was unable to answer the questions or refer her to specialized care in San Antonio.
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From page 267... ...
Initially she went to the Family Focus AIDS Care Treatment and Services Clinic (FFACTS) , found that it primarily treated homosexual men, and consequently felt uncomfortable.
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From page 268... ...
She finally contacted the health department in Seguin, and they referred her to the FFACTS clinic. At that point, one month after she donated blood, the physician told Olivia that she was four months
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From page 269... ...
When Olivia's younger niece worries that Olivia would die and would not be able to take care of the baby or that the baby would die, Olivia responds, "You just have to pray." She is now on triple therapy and Prozac because of her depression. Patient 4: Tina Tina who is six months pregnant, originally grew up in Puerto Rico and was probably infected there by an abusive boyfriend who later died of AIDS.
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From page 270... ...
German, M.D., Ph.D., Program Director Terence Doran, M.D., Ph.D., Clinical Medical Director Rachel Davis, R.N., Assistant Director Yolanda Cantu, M.P.H., Planner, Evaluator Yvonne del Bosco, M.P.H. Valley AIDS Council 2220 Haine Suite 45 Harlingen, TX 78550 Lydia Benavides, Director of Client Service Lisa Casas, Case Manager REDUCING THE ODDS
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