XVIII International AIDS Conference (AIDS 2010)
18–23 July 2010
"Community approach increases identification of HIV-infected children in South Africa"
Tonicah Maphanga, Meredith Sheehy, Scott Kellerman, Waimar Tun, Nomtandazo Mini, Fiona Scorgie, and Elizabeth Mbizvo
South Africa carries the highest burden of pediatric HIV in the world. With prevention of mother-to-child transmission programs only testing a small number of children vertically exposed new programs must be initiated to increase pediatric diagnosis, particularly among children who are orphaned, vulnerable, and more likely to be positive. The Population Council, in collaboration with the South African Social Security Agency (SASSA), initiated a novel community-based approach to increasing HIV testing among this group of higher-risk children.
Fifteen mature caregivers were selected from the community and trained in basic HIV education with a focus on pediatric testing, peer outreach, and referral to pediatric testing services. These outreach workers initiated dialogue on pediatric testing with SASSA social grant recipients from April to September 2009. Grant recipients caring for children between 0 and 14 years were referred to linked government health facilities offering pediatric testing.
A total of 8,500 caregivers were reached. The majority were women (93%), single (58%), and aged between 32 and 97 years (65%). HIV prevalence among the children tested was 14.5 percent compared to 2.1 percent reported in a population survey by the Human Science Research Council in 2008. Among children aged less than 18 months, the HIV prevalence was 6.3 percent while that among those 18 months–10 years was 12.3 percent.
The high HIV prevalence among this population underscores that there are a large number of undiagnosed children in South Africa. Community-based interventions are needed to raise awareness of testing children, especially among those under the care of nonbiological caregivers who are unlikely to know the HIV status of the parents.
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