Despite testing program, children with HIV remain undiagnosed

July 25, 2017

A two-year clinic-based HIV testing program in Zimbabwe failed to diagnose many cases of HIV in children in the surrounding area, Dr. Victoria Simms from the London School of Hygiene & Tropical Medicine, UK, and colleagues, report in PLOS Medicine.

Worldwide, an estimated 1.8 million under the age of 15 are living with HIV, most in sub-Saharan Africa, and they often go without treatment due to under-diagnosis. In the new study, researchers at the Biomedical Research and Training Institute launched a provider-initiated testing and counseling (PITC) program in Harare, Zimbabwe, offering an HIV test to every child aged 6-15 who came into any of 7 local clinics during a two-year timespan. After the two years, the researchers did a house-to-house survey in the same area, testing children aged 8-17 for HIV using an oral test.

2.6% (95% CI 2.2-3.1%) of children tested in the house-to-house survey were HIV positive, and over a third of those (37.7%; 95% CI 29.8-46.2%) were undiagnosed. Based on the survey results, the researchers estimated that the two year PITC program had identified between 18% and 42% of previously undiagnosed children in the community. This extrapolation is limited by the lack of a baseline survey. In addition, under-reporting of known HIV infection is an inherent problem when using self-report.

"In order to diagnose all children with HIV it is not enough to test every child who comes to a clinic, because some HIV positive children either do not visit a clinic often or do not go with a guardian able to give consent for them to take an HIV test," the authors say. "Other methods, such as community-based testing or targeted tracing, must be tried to reach the children who cannot be tested in the clinic."

In an accompanying Perspective, Marguerite Lightfoot of the University of California San Francisco and colleagues discuss the limitations and challenges of PITC to diagnose HIV in children and adolescents. "PITC can play an important role in increasing uptake of testing among older children and adolescents, but needs to better address barriers to testing in this population, and is likely not sufficient on its own," they write.

Explore further: Barriers to HIV testing in older children

More information: Simms V, Dauya E, Dakshina S, Bandason T, McHugh G, Munyati S, et al. (2017) Community burden of undiagnosed HIV infection among adolescents in Zimbabwe following primary healthcare-based provider-initiated HIV testing and counselling: A cross-sectional survey. PLoS Med 14(7): e1002360. doi.org/10.1371/journal.pmed.1002360

Related Stories

Barriers to HIV testing in older children

May 27, 2014
Concerns about guardianship and privacy can discourage clinics from testing children for HIV, according to new research from Zimbabwe published this week in PLOS Medicine. The results of the study, by Rashida A. Ferrand of ...

New HIV self-testing kit aims to increase diagnosis rates

July 4, 2017
A new study from UCL, London School of Hygiene & Tropical Medicine, and Public Health England seeks to discover whether providing free HIV self-tests to men, transgender men and transgender women who have sex with men could ...

Giving women HIV self-tests promotes male partner testing

November 8, 2016
Providing pregnant and postpartum women in sub-Saharan Africa with multiple HIV self-tests can make it more likely their male partners will be tested for HIV compared to a standard approach of distributing invitation cards ...

Home- versus mobile clinic-based HIV testing and counseling in rural Africa

December 16, 2014
Home- and community-based HIV testing and counselling services can achieve high participation uptake in rural Africa but reach different populations within a community and should be provided depending on the groups that are ...

Innovative HIV self-testing study empowers young women in rural South Africa

November 30, 2016
A Public Health research unit at Wits University is leading a study that enables young women in rural South Africa to test themselves for HIV.

Recommended for you

HIV-AIDS: Following your gut

September 18, 2017
Researchers at the University of Montreal Hospital Research Centre (CRCHUM) have discovered a way to slow viral replication in the gastrointestinal tract of people infected by HIV-AIDS.

Study finds cutbacks in foreign aid for HIV treatment would cause great harm

August 30, 2017
Proposed reductions in U.S. foreign aid would have a devastating impact on HIV treatment and prevention programs in countries receiving such aid, an international team of investigators reports. In their paper published online ...

Cancer drug can reactivate HIV

August 24, 2017
People living with HIV must take a combination of three or more different drugs every day for the rest of their lives. Unfortunately, by following this strict treatment plan, they can suffer from side effects ranging from ...

New injectable antiretroviral treatment proved to be as effective as standard oral therapy

August 3, 2017
Intramuscularly administered antiretroviral therapy (ART) may be as effective for HIV treatment as current oral therapies. This is the main conclusion of a Phase II clinical trial carried out by 50 research centers around ...

Research finds home-based kit would increase HIV testing

July 31, 2017
Research led by William Robinson, PhD, Associate Research Professor of Behavioral & Community Health Sciences at LSU Health New Orleans School of Public Health, has found that 86% of heterosexuals who are at high risk for ...

Scientists divulge latest in HIV prevention

July 25, 2017
A far cry from the 1990s "ABC" campaign promoting abstinence and monogamy as HIV protection, scientists reported on new approaches Tuesday allowing people to have all the safe sex they want.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.