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Date of Report:
04/2009
Source:
National HIV/AIDS Clinicians' Consultation Center
Clinicians caring for HIV-infected pregnant women and their infants want to provide the highest quality care. Even clinicians who have received training in HIV can encounter complex treatment issues in preventing transmission from mother to child. Clinicians at any level of experience can benefit from up-to-date information and real-time consultation from experts. Consultation in conjunction with face-to-face training from AETC faculty members can ensure the best quality care to prevent transmission and provide the foundation for continuing care for HIV-positive mothers and their children.
The Perinatal HIV Hotline at 888-448-8765 provides direct access to medical experts for clinical consultation, tailored to the needs of each caller. It is free, confidential and available 24 hours a day. The Hotline is staffed by a multidisciplinary team of clinicians with expertise in perinatal HIV care, including infectious disease specialists, family physicians, internists, obstetricians, and clinical pharmacists.
Sample Perinatal Call:
A clinician who had received training on HIV testing and initial treatment of HIV in pregnancy from her regional AETC tested a 28-year-old pregnant woman at 36 weeks gestational age. The patient tested HIV-positive. From what she had learned previously, the clinician knew how to proceed immediately with the mother, but was unsure what needed to be done upon presentation in labor to prevent transmission to the infant. She called the Perinatal HIV Hotline to discuss appropriate medications and care for the mother and infant.
The Perinatal HIV Hotline works in conjunction with the AETCs to reach clinicians who need additional information on HIV management. It is part of the National HIV/AIDS Clinicians' Consultation Center (NCCC) in the University of California San Francisco at San Francisco General Hospital, which has been operating the National HIV/AIDS Telephone Consultation Service (Warmline) since 1993 and the National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline) since 1997.
The NCCC also operates a Perinatal HIV Clinicians Network -- a national directory of perinatal HIV experts linked to the Hotline. The Network can connect clinicians with local resources so patients can remain in care in their communities. Connections to Network providers are tailored to each location and clinical situation, using the regional and local AETCs and other resources to link patients to care. Network providers are available to provide one-time consultation, co-management, or to accept complete transfer of care.
Sample Network Call:
A midwife in a rural town called the Perinatal HIV Hotline regarding a 16-week pregnant patient whose routine HIV screening test and confirmatory tests were positive. The midwife is in practice with an obstetrician. They were eager to train their entire staff on managing HIV in pregnancy and would like to co-manage the patient's care with a clinician experienced in managing HIV.
The Perinatal HIV Clinicians Network Coordinator contacted the regional AETC. Together they identified clinicians within a two-hour radius of the patient, including an HIV/hepatitis specialty care nurse who travels bi-weekly with an infectious disease specialist to a clinic in the patient's town. The midwife and specialty nurse agreed on co-managed care for the patient, with regular calls from the midwife/obstetrician team to the Perinatal HIV Hotline.
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