STRUCTURE OF A PRIMARY-CARE SUPPORT SYSTEM TO COORDINATE COMPREHENSIVE CARE FOR CHILDREN AND FAMILIES INFECTED AFFECTED BY HUMAN-IMMUNODEFICIENCY-VIRUS IN A MANAGED CARE ENVIRONMENT/

Background. Children with HIV infection require coordinated primary an d tertiary care. Objectives. To describe the structure of the Wisconsi n HIV Primary Care Support Network, a decentralized program for care o f children and families infected or affected by HIV infection. Methods . Review of data concerning all children with HIV infection included i n the Network's database. Results. In this Network centralized HIV spe cialists work with primary care practitioners throughout Wisconsin to assure that children with HIV infection have access to care of uniform quality no matter where they live. Network staff care for children wi th HIV infection both directly and through the education and support o f primary care providers. Care requirements are outlined in a state-pu blished protocol supplied to practitioners. Audit of care is possible because of a centralized data collection system, and ongoing feedback and education occur via the activities of nursing care coordinators an d both hospital- and community-based social workers. Conclusions. This system of care may serve as a model for care delivery to children wit h HIV infection in low prevalence areas and may be applicable to the c are of children with other chronic diseases being cared for in a manag ed care environment.