CSWG Policy Brief: Family-based index case testing to identify children with HIV

Paediatric HIV treatment coverage is stagnating. The most recent estimates suggest that only 46% of children living with HIV are on treatment, well below the AIDS Free target of 1.6 million by the end of 2018. A key challenge is to identify children who are living with HIV that have been missed through routine testing services.

For children in the 0-14 year age group, over 95% of HIV infections are acquired as a result of vertical transmission. As a result, historical approaches to pediatric diagnosis have tended to focus on early infant diagnosis (EID) within the context of prevention of mother-to-child-transmission (PMTCT) programs.

Testing the family of adult or child ‘index’ cases can serve as an entry point for identification of children living with HIV not identified through PMTCT program
testing. This type of family-based approach to HIV testing and service delivery enables parents and their children to access care as a unit. Such approaches may improve retention and offer a convenient service for families affected by HIV.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more