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Date of Report:
01/2008
Source:
National HIV/AIDS Clinicians' Consultation Center
Since the inception of the AETC program, distance-based clinical consultation has been integral to the comprehensive mission of the AETCs. Consultation helps clinicians provide the best HIV/AIDS care through capacitybuilding and case-based HIV education. The National Clinicians' Consultation Center (NCCC) provides a dedicated consultation service to complement the AETC program's face-to-face education and training efforts. Over the course of its 14 years, the NCCC has answered some 120,000 consultation calls. The Center receives more than 1,000 calls a month from clinicians throughout the United States.
In 1993, Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) recognized the need for a readily available clinical consultation service to augment the work of the regional AETCs. The National HIV Telephone Consultation Service (Warmline), initially part of the Pacific AETC site at San Francisco General Hospital, expanded their existing consultation service to provide free, national clinical consultation on preventing and managing HIV/AIDS. In those first years, most calls concerned management of opportunistic infections and HIV/AIDS symptoms. Over time, with the development of antiretroviral (ARV) drugs, there was a dramatic shift to questions about ARV therapy. Now, about two-thirds of Warmline calls concern complicated ARV issues from clinicians with little HIV treatment experience to those who are well-versed on complex ARV resistance.
In 1997, the consultation service, now a national AETC center, expanded further to include the National Clinicians' Post- Exposure Prophylaxis Hotline (PEPline) for advice on managing occupational exposures to HIV and blood-borne pathogens. Because these exposures are often crisis situations demanding immediate action, the PEPline is a 24-hour hotline. The PEPline answers calls from clinicians in emergency departments, occupational health services, and other clinical sites. The PEPline is an integral component of national efforts including use of safety devices, infection control training, and postexposure management that together have resulted in no documented HIV transmissions to healthcare personnel since 2001.
The NCCC expanded again in 2004 to address the key issue of preventing mother-to-child HIV transmission. The National Perinatal HIV Consultation and Referral Service (Perinatal Hotline) was launched to provide 24-hour advice on testing, diagnosing, and treating HIV-infected pregnant women and their infants. Although the number of mother-tochild transmissions has dropped dramatically with testing and treatment interventions, each transmission has enormous consequences. Along with the Perinatal Referral Service, which links patients to healthcare providers, the Perinatal Hotline hopes to help eradicate these transmissions.
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