HRSA Institutes Pediatric AIDS Service Grants

In the first years of HIV/AIDS, some believed that perinatal transmission was not a risk factor for HIV. In his blockbuster book, And the Band Played On, Randy Shilts documents a meeting in which a clinician reporting HIV infection among his infant patients was regarded with suspicion. That suspicion soon disappeared as it became abundantly—and tragically—clear that perinatal transmission was, indeed, possible. Moreover, it was already costing lives.

Pediatric AIDS Service Demonstration Grants were awarded beginning in 1988, and the program was funded from 1988 through 1993. During its life, the program helped grantees in hard-hit cities build the Nation’s first HIV/AIDS care programs targeting children and their families.

Demonstration grants were informed by work both inside and outside the Federal Government, such as the 1987 U.S. Intergovernmental Task Force on AIDS Health Care Delivery and the Surgeon General’s Workshop on Children With HIV Infection and Their Families.

The grants responded to many harsh realities. HIV-positive children were most often born to severely overburdened families. Most women and children infected with AIDS lacked health insurance. Some infants were abandoned in hospitals. Few foster care arrangements were available for babies who were being orphaned by the epidemic.

Pediatric AIDS Service Demonstration Grants made a whole new level of care available to families—especially to children. They successfully addressed the unique needs of women and children and gave the Nation a model for developing programs in new locations. Ultimately, these grants became the framework for Title IV (Part D) of the CARE Act for women, children, infants, and youth.