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Remembering the Children: Implementation and Success of a Robust Method for Identifying and Testing Children of HIV
Christopher Darlow1, Peter Tovey2, Fiona Wallis2
1York Teaching Hospital NHS Trust, Mongate Health Center, 31 Monkgate, York YO31 7WA, UK ; Centre for Immunology and Infection, Department of Biology, HYMS, University of York, Heslington, York YO10 5DD, UK.
Insights
A new method effectively identifies children of HIV patients needing testing. This approach ensures children receive timely human immunodeficiency virus (HIV) testing, preventing potential undiagnosed cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Children of individuals with HIV are often overlooked by healthcare services.
- There is a need for effective methods to identify and test children at risk of HIV.
- Current literature lacks widespread, robust strategies for this demographic.
Purpose of the Study:
- To implement and audit a new proforma and multidisciplinary pathway for identifying and testing children of HIV patients.
- To assess the uptake, effectiveness, and outcomes of the implemented identification and testing strategy.
Main Methods:
- A one-page proforma and multidisciplinary pathway were introduced in December 2011.
- An audit was conducted 12 months later to evaluate the proforma's uptake and the outcomes for identified children.
- Data collected included proforma completion rates, number of children identified for testing, and testing outcomes.
Main Results:
- The proforma achieved a high completion rate (94.6%) among eligible patients.
- Of 118 identified offspring, 25 (21.5%) were untested, including 10 children under 18.
- All tested children, including those referred, ultimately tested HIV negative.
Conclusions:
- The developed identification method is robust, user-friendly, and empowers healthcare providers.
- Implementing such strategies nationwide is recommended to prevent deaths from undiagnosed HIV in children.
- This approach serves as a vital safety net for identifying at-risk pediatric populations.
Abstract:
Background. Children of HIV patients are a historically neglected demographic by HIV services. It has been recommended by CHIVA that HIV services have a robust method of detecting and testing untested children. We note that no such method is either in widespread use or in the literature. Method. In December 2011, a one-page proforma to identify HIV untested children and a clear multidisciplinary pathway to test them were implemented. Twelve months later the uptake of the proforma and pathway, the numbers of patients and children identified for testing, and their outcomes were audited. Results. The proforma was completed in 192/203 (94.6%) eligible patients. Twenty-five (21.5%) of 118 identified offspring had not been tested. Ten (8.5%) of these were <18 years old. All were reported to be clinically well. Ten children were referred for testing, seven were tested immediately, and three were tested within 18 months of identification. All children were tested HIV negative. Discussion. We have identified a method of identification that is easy and robust and provides a user-friendly safety net to empower healthcare providers to identify and test children at risk. We recommend the implementation of such strategies nationwide to prevent death due to undiagnosed HIV in children.
