Population Council Research that makes a difference

Abstract

Identifying and testing children at increased risk for HIV through caregivers: The Caregiver Project (PDF) 
Poster presentation at 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention, Cape Town, 19-22 July
Mini,Nomtandazo Patricia; Scorgie,Fiona; Sheehy,Meredith; Kellerman,Scott E.
Publication date: 2009


Background
South Africa has the largest number of children living with HIV, yet access to pediatric HIV testing and care is lacking. Few pediatric testing opportunities beyond PMTCT exist, and many of the most-at-risk children are orphaned by HIV and cared for by other family members with limited access to HIV information. The Caregiver Project engaged caregivers accessing government-administered grants and referred them for pediatric testing

Methods
This intervention occurred over three months at six grant-distribution sites in Rustenburg and East London, South Africa. Caregivers were administered a brief survey, encouraged to get children in their care tested for HIV, and given referral cards that enabled anonymous monitoring of the number of children who were successfully brought in by their caregivers for HIV testing services.

Results
1,425 caregiver grant recipients participated: average age 43; 93 percent were female; 58 percent were single, and 55 percent had some secondary education. Sixty-three percent had biological children, 59 percent cared for nonbiological children, and 23 percent cared for both biological and nonbiological children. On average there were two children per caregiver. Ninety-two percent of caregivers reported interest in getting children in their care tested for HIV. Only 31 percent of biological children and 23 percent of nonbiological children in their care had been HIV tested. Seventy-seven percent of respondents had at least one child in their care that had never been tested. Resulting from this intervention, at least 15 children accessed pediatric HIV testing services, although we predict more children were served outside of the referral card tracking system.

Conclusions
The Caregiver Project is working to tailor pediatric HIV testing messages and modes of delivery to this population of elderly caregivers, particularly grannies. Future evaluations will determine whether pediatric testing messages delivered by an age-appropriate peer group will result in more children being tested and diagnosed with HIV.