Tools for HIV-Exposed Infant Care and Infant Virologic Testing

CDC-Atlanta Maternal Child HIV Branch and International Lab Branch, in collaboration with partners, have developed tools to support health care workers and laboratorians to provide services to HIV-exposed infants (HEI), including infant virologic testing. These include a flipchart on HEI care, a job aid for clinics collecting dried blood spots (DBS), a job aid for laboratories working with DBS and educational videos to train health care workers on DBS collection, drying and packaging for early infant diagnosis and viral load monitoring.

What is the HIV-Exposed Infant Care and Testing Toolkit?

This toolkit contains practical tools and training materials to guide the health care worker in providing clinical care and testing to HIV-exposed infants (HEIs).

Why was the Toolkit developed?

This toolkit was developed to support health care workers and laboratorians in improving HEI testing and care through final HIV diagnosis.

Despite dramatic global progress with implementing prevention of mother-to-child HIV transmission (PMTCT) programs, gaps still remain in the delivery of care and testing services to HEIs in order to reduce their morbidity and mortality and prevent HIV transmission. There is an urgent need for tools and strategies to support systematic early identification of HEIs, enrollment and retention in care throughout breastfeeding, and testing according to national algorithms until final HIV diagnosis after the end of the breastfeeding period.

How is the Toolkit organized?

Are there other useful resources available for countries to learn from?

Related resources include the Treatment Literacy Guide for Pregnant Women and Mothers Living with HIV and the HIV Point-of-Care Diagnostics Toolkit.

Who is the toolkit for?

Health care workers and laboratorians are the primary audience for this toolkit. The tools may also be helpful to program managers and other stakeholders who mentor and train health care workers.

How can you make the most of this toolkit?

The resources in this toolkit were designed to be used independently to support specific training or mentorship objectives based on health care worker and laboratorian needs but can also be combined for use in trainings on PMTCT and HEI care. The intended use of tools is described below:

• Care of the HIV-exposed infant flipchart: can be distributed to health facilities for use in antenatal and postnatal care for HIV-positive women.
• DBS collection for EID video: can be used to train new staff or provide refresher trainings for existing staff; refresher trainings may be particularly useful for facilities with high DBS specimen rejection rates. Use of the DBS collection video should be combined with practical training and mentorship.
• DBS job aids for clinics: can supplement the video and provide ongoing reminders for health care workers on the proper procedures for DBS collection, drying and packaging.
• DBS job aids for the laboratory: can be used in training for laboratorians and displayed in the laboratory for easy reference.

How was the toolkit developed?

These tools have been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention (CDC). The videos on DBS collection for Early Infant Diagnosis were developed through a partnership between CDC and Roche.