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Dryad

Data from: They are likely to be there: using a family-centered index-testing approach to identify HIV-positive children in Kenya

Abstract

In Kenya, only half of children with an HIV-positive parent have been tested for HIV. The effectiveness of a family-centred index-testing approach to identify children (0-14 years) living with HIV was examined.  A retrospective clinical record review was conducted among adult index patients newly enrolled in HIV care between May–July 2015 and family outcomes were followed through May 2016 at 60 high-volume clinics in western Kenya. HIV testing uptake and results, health facility level, enrollment into care and antiretroviral therapy (ART) initiation were abstracted. Chi-square test compared yield (percentage of HIV tests positive) among children tested through family-centred index testing to outpatient and inpatient testing approaches for the same age category, health facilities and time period. Review of 1,937 index client charts led to the identification of 3,005 eligible children for testing. Of 2,848 (94.8%) children tested through family-centred index testing, 127 (4.5%) were HIV-positive, 100 (78.7%) were linked to care, and 85 of those eligible (91.4%) had initiated ART by May 2016. Family testing resulted in higher yield as compared with inpatient 1.8% (p<0.001) or outpatient testing 1.6% (p<0.001).    The absolute number of HIV positive children identified, however, was highest with outpatient testing (338 HIV positive children identified out of 27,402 tested). The family testing approach resulted in a high HIV identification yield for children and demonstrated promise in achieving the first two 90’s of the 90-90-90 targets for children, with additional effort required to improve linkage from testing to treatment.