Statistics have shown that if an HIV positive mother is not treated, there is nearly a 25% chance that the virus will be passed to her baby. With proper medication, an HIV positive mother can reduce her chances of passing the virus to her baby by less than 1%.
The Florida Department of Health and the Florida Department of Health in Miami-Dade County hope to eliminate the transmission of HIV from mothers to their newborn children. The Perinatal HIV Program, works alongside multiple partners to ensure that HIV infected mothers receive adequate perinatal care by regulatory action, and technical assistance. In addition, assistance may include referrals to Healthy Start, case management, and the Targeted Outreach for Pregnant Women Act Prevention.
Florida law requires all pregnant women to be tested for sexually transmitted infections (STI) including, HIV, chlamydia, gonorrhea, hepatitis B, and syphilis at the initial prenatal care visit and again at 28 to 32 weeks gestation. Women who present in labor and delivery or within 30 days post-partum with no record of STI testing after 27 weeks gestation are considered at a high risk and should be tested for HIV, hepatitis B, and syphilis.
Proper medication for the mother refers to a three-part regimen of antiretroviral medications, administered to the mother during pregnancy, labor, delivery, and to the newborn immediately after birth.
The Florida Department of Health partners with HIV-specialized pharmacies to significantly improve patient outcomes. Baby Rxpress provides HIV medication to HIV exposed and infected newborns prior to leaving the hospital. This plan is used when families do not have insurance, money to pay for the medication, and/or transportation to a pharmacy.
Baby Rxpress Program
The Florida Department of Health (DOH) has a program to provide Retrovir (AZT) and Viramune for HIV-exposed newborns at no cost to the family when they have no other means to pay for the medication. Here’s how it works:
- DOH has a credit account at previously identified Walgreens stores
- The account will only pay for these two drugs only
- The physician will write a prescription for the drug
- Either the perinatal nurse, their designee, or the family can present the prescription and the payment voucher to the Walgreens
- If the nurse gives the voucher to the family, the nurse should sign it as the “authorization signature”
- The drug will be dispensed in exchange for the voucher
- Walgreens will bill DOH for the meds and payment will be made
The goal of this effort is for the mother to leave the hospital with the medicine in hand. There are currently different solutions in different areas of the state – many of which work very well. Some use home delivery pharmacies, and some hospitals dispense the medicine to the mom from the hospital pharmacy (the most common sense solution). If you have an existing system in place, please continue to use it.
Use Baby Rxpress when there seems to be no other option. If you have a family with private health insurance and a doting dad and grandparents, by all means – let them get the Retrovir on their own. This plan is to be the payer of last resort to provide AZT for the babies quickly, when families do not have insurance, money to pay for the medicine, and/or a ride to the drug store.
Perinatal HIV Program Information
Purpose
- To increase the awareness of obstacles that HIV pregnant women face in accessing appropriate medical care by examining case study findings throughout Miami-Dade County.
- To strategize on how to link these women to appropriate care.
- To create ways to reduce women who are lost to care through the referral process.
- To reduce the incidence of incorrect dosing of AZT to premature exposed infants.
- Increase the occurrence of non-HIV certified/non-infectious disease practitioners providing patients with referrals to medical practitioners and/or institutions that do specialize in this care.
- To educate one another on new HIV surveillance trends throughout Miami-Dade County.
- To engage in dynamic collaboration to meet the challenges of a dynamic population.
- To identify ways to strengthen internal medical and psychosocial algorithms to prevent sentinel events
The Miami-Dade County Perinatal HIV coordinator chairs the Perinatal HIV Providers Partnership for the Florida Department of Health in Miami-Dade County which meets quarterly. The members of the partnership include doctors, nurses, Walgreens, TOPWA, AETC, Ryan White Part D, Florida Agency for Health Care Administration, a Haitian health agency, a Hispanic health agency, and a consumer that was HIV infected while pregnant.
HIV/AIDS Surveillance and Data
Information and Forms for Health Care Providers
The Florida Department of Health in Miami-Dade County encourages medical providers that become aware of an HIV infected pregnant woman and/or a newborn infected/exposed to HIV to notify the perinatal HIV coordinator by faxing high-risk pregnancy notification form and/or newborn exposure notification form to 305-470-5533.