Francesca Celletti1, Gayle Sherman, Ahmad H Mazanderani. 1. aElizabeth Glaser Pediatric AIDS Foundation, Geneva 2 bGeneva School of Diplomacy, Geneva, Switzerland cCentre for HIV & STI, National Institute for Communicable Diseases dDepartment of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg eDepartment of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Abstract
PURPOSE OF REVIEW: Only 51% of HIV-exposed infants receive an HIV test between 4 and 6 weeks of age, with even lower repeat testing rates at older ages, and only 49% of infants tested are initiated on antiretroviral therapy. The purpose of this article is to discuss potential solutions for increasing coverage of early infant diagnosis (EID), decreasing turnaround time for result return, improving linkages to care and treatment and fulfilling the objective of improving outcomes for HIV-infected children. RECENT FINDINGS: Differences in HIV testing guidelines have emerged in different countries, with some recommending HIV testing at birth. Although EID programs are not yet optimal, some solutions have proven successful including the use of short message service printers, community-based interventions and support and education of mothers. Birth and EID point-of-care testing have emerged as potential game changers for improving EID programs. SUMMARY: For EID programs to impact on child health outcomes, by preventing HIV-associated morbidity and mortality, and provide more value than a mere surveillance tool, efforts need to be aligned toward the implementation of a comprehensive set of interventions that take cognizance of different contexts, epidemiology and health systems, and that are backed by political and community support.
PURPOSE OF REVIEW: Only 51% of HIV-exposed infants receive an HIV test between 4 and 6 weeks of age, with even lower repeat testing rates at older ages, and only 49% of infants tested are initiated on antiretroviral therapy. The purpose of this article is to discuss potential solutions for increasing coverage of early infant diagnosis (EID), decreasing turnaround time for result return, improving linkages to care and treatment and fulfilling the objective of improving outcomes for HIV-infectedchildren. RECENT FINDINGS: Differences in HIV testing guidelines have emerged in different countries, with some recommending HIV testing at birth. Although EID programs are not yet optimal, some solutions have proven successful including the use of short message service printers, community-based interventions and support and education of mothers. Birth and EID point-of-care testing have emerged as potential game changers for improving EID programs. SUMMARY: For EID programs to impact on child health outcomes, by preventing HIV-associated morbidity and mortality, and provide more value than a mere surveillance tool, efforts need to be aligned toward the implementation of a comprehensive set of interventions that take cognizance of different contexts, epidemiology and health systems, and that are backed by political and community support.
Authors: Matthew R Sandbulte; Brad J Gautney; May Maloba; Catherine Wexler; Melinda Brown; Natabhona Mabachi; Kathy Goggin; Raphael Lwembe; Niaman Nazir; Thomas A Odeny; Sarah Finocchario-Kessler Journal: Pilot Feasibility Stud Date: 2019-01-25