Some of the women most at risk of unhealthy pregnancies and births are also among the most difficult to find, but TOPWA has found a way to do so.

TOPWA is an innovative outreach program for pregnant women at risk of HIV, HIV positive and/or pregnant substance abusing women. Some of these women may not have access to prenatal care. Trained staff are able to work traditional and non-traditional hours, looking for women in places they frequent – laundromats, business establishments, housing complexes and elsewhere. They engage them, develop trust, and let them know the services that are available to them.

The goals are to reduce the risk of transmission of HIV/AIDS to newborns, lower the risk of substance exposure to newborn infants, and to reduce endangerment to newborns. Since 1999, 100% of babies whose mothers are HIV positive and enrolled in TOPWA – Palm Beach County have tested HIV negative. These babies are followed for a minimum of five months to ensure they continue to be healthy.