Clinical Care & Case Management of People Living with HIV

Resources for Preconception through Postpartum Care

People living with HIV have special reproductive health needs. Addressing plans for building a family in advance can improve health outcomes for partners and infants. During pregnancy, women living with HIV may require enhanced, coordinated medical and psychosocial care through postpartum period. This webpage brings together a range of resources about meeting the special reproductive health and healthcare needs of people living with HIV. The resources below illustrate how perinatal services can be organized and delivered.

This toolkit was developed by the CDC’s Elimination of Perinatal HIV Comprehensive Care Working Group.

Resources

Organization of Services for Pregnant Women Living with HIV in a Jurisdiction

  1. CDC’s Elimination of Perinatal HIV Comprehensive Working Group: Essential Elements of Perinatal HIV Service Coordination  
  2. CDC’s Elimination of Perinatal HIV Comprehensive Working Group: Perinatal HIV Services Coordination: Closing Gaps in the HIV Care Continuum for Pregnant Women and Eliminating Perinatal HIV Transmission Webinar

HIV Testing and Counseling of Pregnant Women

  1. CDC: Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings
  2. CDC: Routine early prenatal, third trimester, and screening in labor and delivery should follow CDC’s updated diagnostic algorithm
  3. ACOG: Routine HIV Screening Guidelines.
  4. Clinician Consultation Center: Compendium of State HIV Testing Laws
  5. CDC’s Elimination of Perinatal HIV Real Time Case Finding Working Group: HIV Testing Recommendations for Women: An Important Step to Achieve Perinatal Elimination Webinar
  6. Washington State Department of Health: Screening and Management of Maternal HIV Infection: Implications for Mother and Infant

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Preconception/Interconception Care of Women Living with HIV

  1. HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission: Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States  
  2. CDC and the U.S. Office of Population Affairs: Providing Quality Family Planning Services
  3. CDC: Preconception Care Toolkit
  4. National Preconception Health and Health Care Initiative: Before, Between & Beyond
  5. ACOG: Clinical Content of Preconception Care
  6. ACOG: Gynecologic Care for Women and Adolescents with Human Immunodeficiency Virus
  7. The March of Dimes: Before or Between Pregnancies
  8. CDC: Preconception Care and Health Care Resource Center
  9. The Society of Obstetricians and Gynecologists of Canada: Canadian HIV Pregnancy Planning Guidelines
  10. CDC’s Expert Panel on Preconception and Reproductive Health: Reproductive Health and HIV: Preconception Care, Family Planning & Safer Conception for HIV-Discordant Couples Webinar
  11. AETC National Coordinating Resource Center: How to Locate a Family Planning Clinic or Ryan White Clinic
  12. HIVE: Engaging HIV+ Men in Reproductive Topics

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Comprehensive Management of the Pregnant Woman Living with HIV

Perinatal Guidelines Resources
  1. HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission: Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States
  2. François-Xavier Bagnoud Center: Guidelines for the Use of Antiretroviral Therapy in Pregnancy
  3. François-Xavier Bagnoud Center:What Women Need to Know

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Clinician Tools for HIV + Pregnant Women
  1. The Antiretroviral Pregnancy Registry
  2. Washington State Department of Health: Guidelines for Management of HIV+ Pregnant Women Birthing in Washington State Hospitals Prenatal Provider Checklist
  3. Dartmouth-Hitchcock Family HIV Program: Checklist for Care of HIV+ Pregnant Women
  4. Children’s Hospitals and Clinics of Minnesota: Perinatal HIV Service Delivery Plan
  5. The Family Health Center of Worcester: Delivery Plan for Pregnant Women Living with HIV
  6. The University of Miami: Standard Operating Procedure: OB/GYN Prenatal Immunology Clinic
  7. The University of Miami: Standard Operating Procedure OB/GYN Care of Addicted Pregnant Women
  8. The University of Miami: Standard Operating Procedure: OB/GYN Centering Program
  9. HIVE: Antepartum Care Template
  10. HIVE: Antepartum Provider Orders
  11. HIVE: Intrapartum Provider Orders
  12. HIVE: Orders for Maternal Postpartum Care
  13. PACPI: Best Practices for HIV-Positive Women in Labor
  14. PACPI: Care of HIV-Positive Women in Labor

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Tools for Infant Prophylaxis and HIV Prevention
  1. HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission: Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States
  2.  HHS Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children—A Working Group of the Office of AIDS Research Advisory Council (OARAC): Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection
  3. International Maternal Pediatric Adolescent AIDS Clinical Trials Network: IMPAACT
  4. Clinician Consultation Center: Rapid Perinatal HIV Phone Consultation
  5. Fairview Health Services: Orders for HIV-exposed infant prophylaxis
  6. The University of Miami: Standard Operating Procedure Pediatric Screening Protocol - Infant
  7. The University of Miami: Standard Operating Procedure Pediatric Screening Clinic – Mother/Baby Care
  8. The University of Miami: Pediatric Screening Guidelines
  9. HIVE: Orders for Infant HIV Prophylaxis
  10. HIVE: Breastfeeding Protocol for Mothers Whose Sex Partner is HIV+
  11. PACPI: Best Practices for Care of Infants with Perinatal Exposure to HIV
Tools for Clinical Care of Pregnant Women at Risk for HIV
  1. U.S. Public Health Service: Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2014 Clinical Practice Guideline
  2. CDC: Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV— United States, 2016
  3. HIVE: PrEP Essentials Pocket Card
  4. HIVE: SOAP Note for the Prenatal care of HIV-Negative Women with HIV-Positive Sex Partners
International Resources

Canadian resources regarding clinical care during pregnancy and postpartum are available for reference, however, these tools may require adaptation for US treatment guidelines.

  1. The Society of Obstetricians and Gynecologist of Canada: Guidelines for the Care of Pregnant Women Living With HIV and Interventions to Reduce Perinatal Transmission
  2. Alberta Health Services and Covenant Health: Protocol for the Prevention of Perinatal HIV Transmission
  3. BC Women’s Hospital and Heath Centre: Management of Women and Infants in the Intrapartum Period

Case Management During Pregnancy and Postpartum

  1. CDC’s Elimination of Perinatal HIV Comprehensive Care Working Group: Assessment Tool: Creating a Safety Net to Enhance Postpartum Retention In HIV Care
  2. CDC’s Elimination of Perinatal HIV Comprehensive Care Working Group: Structured Guidance for Postpartum Retention in Care
  3. The Michigan Department of Community Health: Suggested Guidelines for HIV Case Management for Pregnant Women in Michigan
  4. Florida Department of Health in Miami-Dade County: Perinatal HIV Services
  5. Florida Department of Health in Miami-Dade County: High-Risk Pregnancy Notification Form
  6. The Family Health Center of Worcester: MCH Service Care Protocol for HIV+ Pregnancies
  7. PACPI: Pediatric AIDS Chicago Prevention Initiative (PACPI) Standard Operating Procedures
  8. PACPI: Enhanced Case Management Consent
  9. François-Xavier Bagnoud Center: Take Care of Yourself and Your Family After Your Baby is Born

Training and Support Tools

  1. Clinician Consultation Center: Rapid Perinatal HIV Phone Consultation
  2. Clinician Consultation Center: Perinatal ReproID HIV Listserv
  3. The Capacity Building Assistance (CBA) Provider Network: Provider Directory
  4. AIDS Education and Training Center (AETC) Program: National Coordinating Resource Center
  5. ACOG: Women & HIV

Support for Community Members

  1. The Well Project
  2. HIVE: HIVE Blog

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