The acceptability of routinely offered pediatric HIV testing at Mbagathi hospital pediatric outpatient clinics

Abstract

Background: Routine screening for HIV is timely and cost-effective(1) but low uptake rates have been reported in general outpatient clinics(2). Routine HIV testing in the outpatient setting is not done well and missed opportunities have been noted (3). Study Objectives: The primary objective of this study was to determine the acceptability of routinely offered HIV testing among children at Mbagathi Hospital pediatric outpatient clinics. Secondary objectives were to describe factors associated with testing and to explore perceptions and experiences on routine child HIV testing among caregivers and health workers respectively. Methods: A cross-sectional survey method was adopted to determine the HIV testing acceptability rate and associated factors. Free listing, case studies and key informant interviews were the qualitative study methods used to explore caregiver and health worker perceptions and experiences. Results: The acceptability of routinely offered pediatric HIV testing was 8.41% among 333 child/caregiver pairs. Lack of perceived risk of HIV infection and need for more time to think were cited as reasons for not accepting testing at 67.88% and 21.19% respectively. Caregivers disclosing their HIV status to their siblings and those with previous HIV testing were 7.6 times and 3.3 times more likely to accept child HIV testing than those disclosing to their spouses or not previously tested; (AOR=7.60; 95% CI: 1.23-46.78; p=0.029) and (AOR=3.33; 95% CI: 1.10 – 10.12; p=0.034) respectively. Children aged above 10 years were 9.85 times more likely to be tested than those less than 1 year (AOR= 9.85; 95% CI: 1.36 – 71.07, p=0.023). Poor health status of a child was a motivator for testing and health workers cited health resources constraints as reasons for poor implementation of routine testing. Conclusions: There is low uptake of routinely offered pediatric HIV testing in the outpatient setting. Further studies are required to develop strategies to optimize uptake of HIV testing among children in this setting.