The staff of the Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children's Hospital currently provide comprehensive primary and specialty care to 110 HIV-infected and HIV-affected infants and children, ranging in age from three months to 19 years. These children represent approximately 50 percent of all known HIV-infected children residing in the Houston metropolitan area. Fifty-five percent of these children are black, and 17 percent are Hispanic. Increasingly, HIV-infected children are referred for care from outside the Houston metropolitan area.
All HIV-infected children followed by BIPAI staff benefit from a comprehensive program of primary and specialty health care. In the interest of continuity of care, each child is followed primarily by one pediatric nurse practitioner, under the supervision of the faculty physicians. The health care team meets weekly to discuss each child's medical, psychological, and social needs.
A Comprehensive Program of Care
All children receive routine immunizations and growth and developmental screening, as well as careful clinical and laboratory follow-up of HIV-disease status and responses to treatment. Children with suspected neuro-developmental delay or regression are referred for evaluation to the Meyer Center for Developmental Pediatrics at Texas Children's Hospital. All children are examined twice annually by a pediatric dentist and at least annually by an ophthalmologist at Texas Children's Hospital. A pediatric psychologist provides assistance as needed. Referral to any other pediatric subspecialty service at Texas Children's Hospital is made on a case by case basis. The families of HIV-infected children benefit from the service of a full-time social worker.
Some HIV-uninfected siblings of children with HIV infection also receive their health care from BIPAI staff. We believe that making this option available to families can ease the burden of chronic illness by simplifying access to health care for uninfected children. We also believe that uninfected siblings of HIV-infected children invariably are HIV-affected and require specialized medical, psychological and social follow-up and management.