Uptake and yield of HIV testing and counselling among children and adolescents in sub‐Saharan Africa: a systematic review

Govindasamy, Darshini; Ferrand, Rashida A; Wilmore, Stephanie; Ford, Nathan; Ahmed, Saeed; Afnan-Holmes, Hoviyeh; Kranzer, Katharina

doi:10.7448/ias.18.1.20182

Cited by 100 publications

(137 citation statements)

References 40 publications

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“…This finding has implications for the implementation of HTC at school and could be one of the major barriers to successful implementation. Govindasamy and colleagues [25] argue that the appropriate age at which learners can provide consent warrants further rigorous investigation.…”

Section: Discussionmentioning

confidence: 99%

Parents Support Implementation of HIV Testing and Counseling at School: Cross-Sectional Study with Parents of Adolescent Attending High School in Gauteng and North West Provinces, South Africa

Madiba

Mokgatle

2016

AIDS Research and Treatment

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Background. A formative assessment of the implementation of HIV testing and counseling (HTC) at school showed high acceptability and willingness to test among learners. However, the success of the proposed HTC depends on the support and acceptability of key stakeholders, including the parents. The aim of the study was to assess the opinions and acceptability of the implementation of HTC at school among parents of adolescents in high school. Methods. This was a cross-sectional household survey conducted with parents of adolescents attending high schools in educational districts in North West and Gauteng provinces, South Africa. Results. A total of 804 parents participated, and 548 (68.3%) were biological mothers, 85 (10.6%) were fathers, and the remaining were other relatives including grandmothers. Almost all (n = 742, 92.9%) parents were in support of implementation and provision of HTC at school, 701 (87.7%) would allow their children to be tested at school, 365 (46%) felt that parental consent was not needed to test at school, and 39.4% preferred to receive the HIV test results with their children. Conclusion. Parents accept the roll-out of an HTC program at school and have a role to play in supporting children who test positive for HIV.

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Section: Discussionmentioning

confidence: 99%

Parents Support Implementation of HIV Testing and Counseling at School: Cross-Sectional Study with Parents of Adolescent Attending High School in Gauteng and North West Provinces, South Africa

Madiba

Mokgatle

2016

AIDS Research and Treatment

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“…One strategy to close pediatric HIV testing gaps is testing children of HIV-infected adults in care; this index case testing (ICT) approach yields a higher likelihood of diagnosing pediatric HIV infection than in the general population [10, 11] and may identify asymptomatic children [10, 12-15]. Additionally, ICT engages adults familiar with the benefits of HIV care who may be amenable to testing their children.…”

Section: Introductionmentioning

confidence: 99%

Brief Report: Disclosure, Consent, Opportunity Costs, and Inaccurate Risk Assessment Deter Pediatric HIV Testing: A Mixed-Methods Study

Wagner

O’Malley

Firdawsi

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Prompt child HIV testing and treatment is critical; however, children are often not diagnosed until symptomatic. Understanding factors that influence pediatric HIV testing can inform strategies to increase testing. Methods A mixed-methods study was conducted at a tertiary hospital in Nairobi, Kenya. Three focus group discussions with health care workers (HCW) and 18 in-depth interviews with HIV-infected adults with children of unknown status were analyzed using thematic analysis. A structured questionnaire was administered to 116 HIV-infected caregivers of children of unknown status to triangulate qualitative findings. Results Analysis revealed 3 key periods of the pediatric HIV testing process: decision to test, test visit, and post-test. Key issues included: decision to test: inaccurate HIV risk perception for children, challenges with paternal consent, lack of caregiver HIV status disclosure to partners/older children; test experience: poor understanding of child consent/assent and disclosure guidelines, perceived costs of testing and care, school schedules, HCW discomfort with pediatric HIV testing; post-test: pessimism regarding HIV-infected children’s prognosis, caregiver concerns about own emotional health if child is positive, and challenges communicating about HIV with children. Concerns about all three periods influenced child testing decisions. Additionally, three challenges were unique to pediatric HIV: inaccurate HIV risk perception for children; disclosure, consent, and permission; and costs and scheduling. Conclusions Pediatric HIV testing barriers are distinct from adult barriers. Uptake of pediatric HIV testing may be enhanced by interventions to address misconceptions, disclosure services, psychosocial support addressing concerns unique to pediatric testing, child-focused HCW training, and alternative clinic hours.

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“…Further, even in HIV-infected infants with an adequate initial response, fewer than 50% maintain protective antibody levels after one year 4,5 . Vaccination after initiation of antiretroviral therapy (ART) may improve the response; however, many HIV-infected infants are not diagnosed and treated before receiving routine measles vaccination 9 .…”

Section: Introductionmentioning

confidence: 99%

Sustained Responses to Measles Revaccination at 24 Months in HIV-infected Children on Antiretroviral Therapy in Kenya

Newman

Njoroge

Magaret³

et al. 2017

Pediatric Infectious Disease Journal

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Background There are limited data on whether HIV-infected children in resource-limited countries who are receiving antiretroviral therapy (ART) are able to produce sustained, protective levels of measles antibody after multiple measles vaccinations. Methods We administered an additional measles vaccine to HIV-infected children 15 months to 12 years of age receiving ART in Nairobi, Kenya. Measles antibody concentrations were determined by enzyme-linked immunosorbent assay (ELISA) at enrollment, one month, 12 months, and 24 months post revaccination. Results At enrollment, 125 (54%) of 232 study participants had protective concentrations of measles antibody. Measles seropositivity increased to 98% of all children at one month post revaccination, but decreased to 71% at 12 months, and 60% at 24 months post revaccination. Measles seroconversion and sustained measles seropositivity among those who were measles seronegative at enrollment was 25% at 24 months post revaccination. In this group, 39% of children with <50 copies/mL plasma HIV RNA measles seroconverted compared with 4% of children with plasma HIV RNA ≥1,000 copies/mL (p=0.018). Conclusions Measles revaccination can result in a sustained antibody response in a subset of HIV-infected children receiving ART, especially among those with HIV suppression.

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Uptake and yield of HIV testing and counselling among children and adolescents in sub‐Saharan Africa: a systematic review

Cited by 100 publications

References 40 publications

Parents Support Implementation of HIV Testing and Counseling at School: Cross-Sectional Study with Parents of Adolescent Attending High School in Gauteng and North West Provinces, South Africa

Parents Support Implementation of HIV Testing and Counseling at School: Cross-Sectional Study with Parents of Adolescent Attending High School in Gauteng and North West Provinces, South Africa

Brief Report: Disclosure, Consent, Opportunity Costs, and Inaccurate Risk Assessment Deter Pediatric HIV Testing: A Mixed-Methods Study

Sustained Responses to Measles Revaccination at 24 Months in HIV-infected Children on Antiretroviral Therapy in Kenya

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