132 Annual Meeting Logo - Go to APHA Meeting Page  
APHA Logo - Go to APHA Home Page

Challenges to keeping newly identified HIV + women engaged in care during the post partum period: The Chicago (Mother Infant Rapid Intervention at Delivery) MIRIAD Experience

Yolanda Olszewski, MPH, MS1, Faridah Love2, Michele Robey2, Cheryl Watson, MS1, and Mardge Cohen, MD3. (1) Research, CORE Center, 2020 W. Harrison St., Chicago, IL 60612, 312-560-1451, yonodey@ameritech.net, (2) Cook County Hospital, 2020 W. Harrison St, Chicago, IL 60612, (3) Medicine, The CORE Center of Cook County Hospital, 2020 W. Harrison Street, Chicago, IL 60612

Background: Rapid HIV testing at labor and delivery (L&D) identifies HIV infection in women with undocumented status. Continued comprehensive HIV care is critical for the health of these women and their infants. Methods: All women entering L&D at six hospitals in Chicago were screened, Eligible women (undocumented HIV status and > 34 weeks gestational age or > 24 weeks if imminent delivery) were tested using OraQuick Rapid HIV-1 Antibody Test. HIV-positive women were offered immediate antiretroviral prophylaxis and participation in a follow-up study. Results: From 11/2001-12/2003, 1,845 women were tested, 10 HIV+ identified (median age = 24.5 years (range 18-42); all African American; median number of pregnancies = 5 (range 1-13)). Fifty percent (5/10) knew their HIV status but failed to link to antenatal care. Women with known status were more likely to lose custody of their infants because of drug use (3), have subsequent pregnancy within 1 year (2), and not receive post-partum HIV care (3) compared to the rest of the newly diagnosed group. All faced one or more of the following problems postpartum: residential instability, abuse, drugs, incarceration, mental health issues. Conclusion: Half the HIV-infected women identified knew their status but did not disclose it. They had not received antenatal HIV care , were more likely than newly diagnosed women to have a repeat pregnancy on follow-up, not have custody of their newborns, and not receive HIV care. Intensive social support, mental health services, family planning, and substance abuse treatment facilitates continuation in care for disenfranchised women.

Learning Objectives:

Keywords: Challenges and Opportunities, HIV/AIDS

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HIV/AIDS Research Roundtable: Perinatal HIV Testing and Prevention

The 132nd Annual Meeting (November 6-10, 2004) of APHA