Promising Strategies for Preventing Perinatal HIV Transmission: Model Programs from Three States

OBJECTIVES: This paper describes and compares three innovative methods for preventing perinatal HIV transmission. Each of these strategies has been developed based on an in-depth assessment of the strengths and weaknesses of existing prevention approaches, and the needs of the populations they serve. METHODS: Florida expanded an existing outreach program to include women in jails in several high-prevalence counties. Incarcerated women were offered testing for pregnancy and HIV and linked to medical and supportive services. One Connecticut hospital sought to increase prenatal HIV testing rates by requiring HIV test results in the electronic medical records. This program is being expanded to other hospitals throughout the state. Louisiana has implemented a systematic review of perinatal data in order to identify potential programmatic enhancements. This review has led to the perinatal fast track system, designed to quickly identify HIV-infected pregnant women and connect them to care. RESULTS: Each program demonstrated improvements in indicators related to prevention of perinatal HIV transmission, such as increased utilization of prenatal care, increased prenatal testing rates, and decreases in perinatal HIV transmission. CONCLUSIONS: These case studies emphasize two key similarities among these programs: the value of collaboration between agencies providing care and services to HIV-infected and high-risk women of childbearing age, and the importance of maximizing opportunities for HIV testing and treatment. These strategies have demonstrated effectiveness in improving health outcomes and reducing perinatal HIV transmission.     

Newborn screening: New opportunities and new challenges

Newborn screening is an old technique for early detection of problems and health promotion. In recent times, genetic breakthroughs have created the possibility of testing for many more newborn conditions. Some states are mandating as many as 20 to 30 tests. This article will review newborn screening, the state of the art, and some of the ethical questions that our technology is raising. Copyright 2002, Elsevier Science (USA). All rights reserved.     

Risk Behaviors of Dominican Adolescents in Their Homeland and in the United States

IntroductionAdolescence is a time of developmental change. The major task of adolescence is to become an independent individual capable of functioning as a contributing adult within culturally expected norms. It is often accompanied by frustration and difficulties with adjustments. One typical response of adolescents to these changes is engaging in high-risk behaviors. The purpose of this study was to compare self-reported high risk behaviors that may lead to unintentional and intentional injuries among adolescents living in the Dominican Republic and Dominican adolescents living in the United States.MethodThis study used a cross-sectional, comparative design with data collection sites in Las Matas de Farfan, Dominican Republic, and Boston, MA, United States. Data were collected using the 99-item 1999 Youth Risk Behavior Survey.ResultsFindings indicated that adolescents in both groups reported similar risk behaviors in all areas; however, there were few differences between the two groups that did exist.DiscussionTo educate youth regarding outcomes of high-risk behaviors, it is necessary for providers to engage in discussion with adolescents regarding specific risk behaviors that are commonly practiced in their homeland or in their cultural groups.     

The Undergraduate Research Fellows Program: A Unique Model to Promote Engagement in Research

Regardless of which research enrichment processes are endorsed by a university, enhancing undergraduate research experiences strengthens the overall quality of the educational process. In supporting the Boyer Commission on Educating Undergraduates in the Research University (1998), the UGRF program and Boston College William F. Connell School of Nursing involve undergraduate students in research projects by preparing the next generation of scholars through the creation of a quality program. These programs can be evaluated overtime and represent a tangible goal for academic institutions committed to research intensive development. This process must be viewed as a critical point in research experience continuum because realistically, a researcher may only be able to model selected aspects of the research process and unable to model the whole spectrum of scholarly behaviors (Meleis, 1992). Helping undergraduates begin to see key aspects of the researcher role through real participation is an important step in helping them advance science through individualized engaged development.