The Mother and Child Alliance (formerly Pediatric AIDS Chicago Prevention Initiative - PACPI) offers enhanced perinatal HIV case management services to pregnant people living with HIV in Illinois who require extra support. An enhanced case manager can work with you to link your client to a variety of services. Mother and Child Alliance (MACA) case managers are available through the 24/7 Illinois Perinatal HIV Hotline at 1-800-439-4079.

Twenty-four hours a day, seven days a week expert, up-to-date, real-time consultation on each individual case is available to assure that all clinical and social issues are addressed for each patient with a preliminary positive result. The intent of the legislation requiring the call is to ensure that experienced case management helps the patient and her family with this information in the very vulnerable time between receipt of the rapid result and receipt of the confirmatory HIV test result. Oftentimes, case management can also provide a home visit and help ensure the return visit to the hospital or clinic to receive the confirmatory results. Hotline staff work with hospitals and providers as a team to make clinical decisions, connect patients with case management, and assure appropriate follow up.

The case manager will meet with the staff that called the Illinois Perinatal HIV Hotline to report the preliminary positive test result and inquire about any particular issues of concern for either staff or the client. The case manager will then request to meet with the client privately (away from family) to discuss options. With permission, the case manager will meet with the family with the goal of stabilizing the situation. Before leaving the hospital, the case manager will update staff on any plans and referrals that might be in process for the client.

Formula feeding is the only way to eliminate the risk of breastmilk transmission of HIV. However, if a person with HIV expresses interest in breast/chestfeeding, shared decision making and non-judgmental counseling should be provided as outlined in the DHHS Perinatal HIV Guidelines Infant Feeding for Individuals with HIV in the United States. Clinicians should consult experts in pediatric HIV if a person with HIV chooses to breast/chestfeed.

The case work is completed and the client is referred to the appropriate follow-up services for people without HIV. The clients are assisted with finding a pediatrician, where to go for benefits (WIC, KidCare) and the case may be transferred to a DHS Family Case Manager where appropriate.

Enhanced case management is intensive case management. It is a field-based service where the case manager brings the services to the client. Enhanced case management is often targeted at especially vulnerable populations, like pregnant people, bringing the case management to their homes and their neighborhoods.

The Hotline provides information about the most up-to-date treatments for pregnant people living with HIV and newborns. This includes medical consultation on HIV related obstetric and pediatric issues.

Traditional case management usually occurs in the case manager’s office, requiring the client to make and keep appointments. Enhanced case management occurs in the field. Case loads for enhanced case managers are small. They usually have one-quarter to one-half of the number of clients that a traditional case manager has. In enhanced case management, the visits are longer and clients usually require more hands on assistance in the field such as escort to appointments, linkage to specialized medical care, outreach and home visits.

Yes, antiretroviral therapy is currently recommended for all individuals living with HIV to reduce the risk of disease progression and to prevent HIV sexual transmission. Additionally, antiretroviral therapy postpartum is also important to help the patient maintain viral suppression prior to subsequent pregnancies.

The Hotline can assist providers in interpreting HIV test results and can offer recommendations for additional testing and care.