One major provider of health care services for mothers and children at risk for or with HIV infection in lower Manhattan is the Pediatrics Infectious Diseases Clinic at Bellevue, part of the Lower New York Consortium for families with HIV. The clinic follows over 300 families, including over 120 children who are HIV positive. Initiated in 1982 with the aid of private philanthropy and now funded in large part by federal support, this program has made major contributions to the understanding of the transmission of HIV from mothers to children and has contributed to their improved care and longevity. The Pediatric Infectious Diseases Clinic relies on a multidisciplinary health care team to deliver care and coordinate it across the many departments and services both within and outside the hospital.
The philosophical orientation of the team is to identify and address all the needs of infected and at-risk children and their families. The team maintains a close relationship with patients and follows them closely, providing the majority of medical and psychosocial care for HIV infected children on an outpatient basis that limits and prevents unnecessary and costly hospitalizations. Thus far, the team has proved successful as indicated by the average daily census of less than 1 HIV-infected children.
The Pediatric Infectious Diseases Clinic meets two days a week, with a clinical case management conference held on a third day. Medical services are provided for the children by Pediatric Infectious Disease Attendings, post-doctoral residents, a pediatrician, a dermatologist and a pedodontist. Medical care for parents is provided in the same clinic by adult infectious diseases specialists and an obstetrician/gynecologist, who see parents while their children are being seen. Psychologists provide developmental testing.
In addition to nursing, staff also includes public health advisors who screen mothers for risk factors, counsel, and initiate testing as well as provide follow-up for mothers in prenatal care; and a counselor who makes home visits, provides emotional support, and aids in follow-up efforts. There are also a full range of clinical social work and child life services. Many of the children being followed have enrolled in a variety of ongoing trials through the Pediatric AIDS Clinical Trials Group.
