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Pediatric HIV Case Identification Across 22 PEPFAR-Supported Countries During the COVID-19 Pandemic, October

Ariana M Traub, Amy Medley, Jessica Gross

    MMWR. Morbidity and Mortality Weekly Report
    |July 14, 2022
    PubMed

    Insights

    Pediatric HIV testing decreased during the COVID-19 pandemic, but mobile and index testing strategies proved effective in identifying children living with HIV (CLHIV). Continued data analysis is crucial for optimizing testing approaches and sustaining progress toward global HIV/AIDS targets.

    Area of Science:

    • Public Health
    • Epidemiology
    • Infectious Diseases

    Background:

    • An estimated 150,000 children (0-14 years) acquired HIV globally in 2020.
    • Optimizing pediatric HIV testing is crucial for linking children living with HIV (CLHIV) to treatment and achieving global HIV/AIDS targets.
    • The COVID-19 pandemic presented challenges to sustained HIV testing and diagnosis efforts.

    Purpose of the Study:

    • To assess changes in pediatric HIV testing and diagnosis in 22 U.S. President's Emergency Plan for AIDS Relief (PEPFAR)-supported countries.
    • To evaluate the impact of the COVID-19 pandemic on HIV testing strategies for children aged 1-14 years.
    • To identify effective strategies for pediatric HIV case identification during the pandemic.

    Main Methods:

    • Analysis of HIV testing data and diagnoses among children (1-14 years) from October 2019 to September 2020 (two quarters pre-pandemic, two quarters post-pandemic).
    • Disaggregation of testing data by age group, testing strategy, and fiscal year quarter.
    • Comparison of testing volumes and case identification rates across different strategies, including outpatient, mobile, and index testing.

    Main Results:

    • Overall HIV testing decreased significantly (40.1%) from Q2 to Q3 2020, with a partial recovery in Q4.
    • HIV case identification among children also decreased (29.4%) from Q2 to Q3, with a slight increase in Q4.
    • Despite declines, mobile testing increased by 38%, facility-based index testing by 8%, and malnutrition-related testing by 7%; these strategies, along with testing in school-aged children (5-14 years), remained vital.

    Conclusions:

    • The COVID-19 pandemic disrupted pediatric HIV testing and diagnosis, necessitating adaptive strategies.
    • Mobile and index testing, alongside targeted approaches for malnourished children and school-aged populations, proved resilient and essential.
    • Continued utilization of programmatic, surveillance, and financial data is recommended to optimize the mix of testing strategies and minimize disruptions in identifying CLHIV.

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