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Reducing HIV Transmission:
The Maternal HIV Consumer Information Project

The Health Care Financing Administration (HCFA) is a Federal agency within the U.S. Department of Health and Human Services. It was created in 1977 to administer the Medicare and Medicaid programs.

HCFA developed the Maternal HIV Consumer Information Project to increase patient and provider knowledge about the availability of drugs that reduce HIV transmission and to expand knowledge of Medicaid eligibility and coverage of prenatal care. In this project, HCFA works with State Medicaid agencies and Departments of Health to provide women of childbearing age with information regarding HIV testing and counseling which, in the event a woman is HIV positive, enables her to make an informed decision about preventing transmission of HIV disease to her baby. The drugs when properly prescribed can help prevent transmission of HIV to infants. The project also stresses that Medicaid pays for HIV counseling, testing, treatment, and medications to prevent transmission of HIV from mother to child. Because there is a high percentage of minority women in Medicaid, HCFA also believes this project will have a positive impact on minority women's health outcomes.

The following are some background facts which led HCFA to develop the Maternal HIV Consumer Information Project:

• Medicaid is the largest single payor of direct medical services to persons living with AIDS. The Medicaid program pays for the care of over 50 percent of all persons living with AIDS and up to 90% of those persons under 18 years of age living with AIDS. In addition Medicaid pays for the care of about 60,000 persons with HIV disease who have not yet progressed to AIDS.
• Of 18 million Medicaid-eligible women, approximately 32,000 are HIV infected; approximately 3,000 are HIV infected and pregnant.
• Given that virtually all new infections in children are transmitted perinatally, ways to overcome and prevent infection in this age group must target both the mother and infant.
• AIDS has become a major cause of death among women and children, representing the fourth leading cause of death among women, ages 25-44, and the seventh leading cause of death among children, ages 1-4. Not surprisingly, experts predict that as more women of childbearing age become infected, the number of children infected will also rise.
• Women with HIV are disproportionately minority and poor. The significance of this projection is most poignant for minorities. For example, in New York City, AIDS is already the leading cause of death in Hispanic children 1 to 4 years of age and is the second leading cause of death for African-American children of the same ages.

Pilot Projects

On World AIDS Day, December 1, 1995, the Maternal HIV pilot started in four states: Rhode Island, Delaware, New Jersey (3 counties), and Florida (5 counties). These sites were chosen because of CDC statistics indicating the highest prevalence of HIV-infected women in the Northeast, along the Atlantic Coast, and in the Southeast.

HCFA's goal is to have a Maternal HIV Consumer Information Project in all States by the end of the year 2000.

If you have questions about HCFA's Maternal HIV Consumer Information Project, contact the person listed in the HCFA regional office nearest to you.

For further information on Medicaid coverage of HIV-positive pregnant women, contact Randolph Graydon, Director, Division of Advocacy and Special Issues in HCFA's Center for Medicaid and State Operations at 410/786-1357 or e-mail at rgraydon@hcfa.gov.

Next:Special Medicaid for HIV positive Mothers

This article was produced by the Health Care Financing Administration and Department of Health and Human Services.

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