HCFA's Maternal AIDS Initiative

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's Maternal AIDS Consumer Information Project was created to increase patient and provider knowledge about the availability of treatments that reduce HIV transmission and to expand knowledge of Medicaid eligibility and prenatal care coverage. In this project, HCFA works with State Medicaid agencies and Departments of Health to provide Medicaid women of childbearing age with information regarding HIV testing and counseling which, in the event that they are HIV positive, enables them to make an informed decision about treatment of their HIV disease. This treatment can help prevent transmission of HIV to infants. 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 to HCFA's development of the Maternal AIDS Consumer Information Project:

• Medicaid is the largest single payor of direct medical services to 50% of all persons living with AIDS and up to 90% of those persons under 18 years of age living with AIDS.
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• 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 infected children 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 deathfor African-American children of the same ages.

Pilot Projects

On Worlds AIDS Day, December 1, 1995, the Maternal AIDS 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.

In the summer of 1997, HCFA will expand the pilot to include ten states and eight metropolitan areas/counties/territories. These include:

For further questions about HCFA's Maternal AIDS Initiative, contact one of the Regional Office AIDS Coordinators listed below:

For further information on Medicaid coverage offered to HIV positive pregnant women, contact Randy Graydon, Co-Director, Office of Beneficiary Services in HCFA Medicaid Bureau at 410/786-1357.