Background: Achieving optimal treatment for all groups of individuals living with HIV is essential to attaining epidemic control. About 191,395 children and adolescents under 19 are living with HIV (C/ALHIV) with only 46,461 (24%) on treatment in Nigeria. In order to close this treatment gap, the pediatric ART saturation strategy (PASS), was developed between care and treatment team and orphans and vulnerable children (OVC) team to ensure identification and treatment of C/ALHIV and return of children who were lost-to-follow-up (LTFU) in the cascade of care back to HIV treatment. Methods: We conducted HIV risk assessments for OVC and their households during a six-month intervention period (April-September 2019) in Akwa Ibom, Cross River and Lagos state identifying children at risk for HIV. HIV testing and positive results were compared at 6 months pre-intervention and 6 months post-intervention. Pearson Chi Square test was used to determine the difference between the outcome of pre-intervention and post-intervention groups. One-way ANOVA was used to determine the differences in the means of the HIV testing indicator data between the three states at 95% CI and post-Hoc test (Tukey HSD) was used to determine the differences (P < 0.05).