Abstract:
Background: Home-based voluntary counseling and testing (HCT)
presents a novel approach to early diagnosis. We sought to describe
uptake of pediatric HIV testing, associated factors, and HIV
prevalence among children offered HCT in Kenya.
Methods: The USAID-Academic Model Providing Access to
Healthcare Partnership conducted HCT in western Kenya in 2008.
Children 18 months to 13 years were offered HCT if their mother was
known to be dead, her living status was unknown, mother was HIV
infected, or of unknown HIV status. This retrospective analysis
describes the cohort of children encountered and tested.
Results: HCT was offered to 2289 children and accepted for 1294
(57%). Children were more likely to be tested if more information
was available about a suspected or confirmed maternal HIV infection
[for HIV-infected living mothers odds ratio (OR) = 3.20, 95% confi-
dence interval (CI): 1.64 to 6.23), if parents were not in household
(OR = 1.50, 95% CI: 1.40 to 1.63), if they were grandchildren of head
of household (OR = 4.02, 95% CI: 3.06 to 5.28), or if their father wasot in household (OR = 1.41, 95% CI: 1.24 to 1.56). Of the eligible
children tested, 60 (4.6%) were HIV infected.
Conclusions: HCT provides an opportunity to identify HIV among
high-risk children; however, acceptance of HCT for children was
limited. Further investigation is needed to identify and overcome
barriers to testing uptake
