Newly diagnosed HIV positive children: a unique index case to improve HIV diagnosis and linkage to care of parents

ABSTRACT

Newly diagnosed HIV positive children may be unique index cases to identify undiagnosed parents. Data was used from the Pediatric Urgent Start of HAART (NCT02063880) trial, which enrolled hospitalized, ART-naïve, HIV positive children ages 0–12 years in Kenya. Exact McNemar’s tests were used to compare proportions of mothers and fathers tested for HIV, linked to care, and on ART at baseline and 6 months. This analysis included 87 newly diagnosed children with HIV who completed 6 months of follow-up. Among 83 children with living mothers, there were improvements in maternal linkage to care and treatment comparing baseline to 6 months (36% vs. 78%; p < 0.0001 and 22% vs. 52%; p < 0.0001). Among 80 children with living fathers, there were increases from baseline to 6 months in the number of fathers who knew the child’s HIV status (34% vs. 78%; p < 0.0001), fathers ever tested for HIV (43% vs. 65%; p < 0.0001), fathers ever tested HIV positive (21% vs. 43%; p < 0.0001), fathers ever linked to care (15% vs. 35%; p < 0.0001), and fathers ever initiated on ART (11% vs. 23%; p = 0.0039). Newly diagnosed HIV positive children can be important index cases to identify parents with undiagnosed HIV or poor engagement in care.

KEYWORDS:

• HIV
• HIV testing
• family testing
• index case testing
• case identification
• HIV care cascade

Acknowledgements

We thank the PUSH study team, caregivers, and children who participated in the trial, the Kenyan Ministry of Health, and our funders for their dedication and support. The authors have no conflicts of interest to disclose.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

INN, LMC, VOO, CM, HMO, SBN, BAR, JS, EMO, DCW, and GJS were supported by National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) [grant number R01 HD023412 and K24 HD054314-06 to GJS, K12 HD000850 to LMC]. JN was supported by the National Institutes of Health (New Investigator Award supported by P30 AI027757). This publication was supported in part by Fogarty International Center (FIC) D43TW009783 to IN. SBN was supported by National Institute of Neurological Disorders and Stroke [grant number K01 NS080637]. ADW was supported by NICHD (F32 HD088204-01). Research reported in this publication was supported by the University of Washington / Fred Hutch Center for AIDS Research, an NIH-funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK.