Factors Associated with Uptake of HIV Testing Among HIV Exposed Infants in Goromonzi District, 2012

Abstract

Background: One of the national ART goals is elimination of pediatric AIDS through Early Infant Diagnosis (EID) and antiretroviral therapy where appropriate. National achievement for HIV test among HIV exposed infants between six and eight weeks of age (Dried blood spot) was 67% against a target of 60% for the year 2012. However, Goromonzi district achieved 12%. Two thirds of childhood deaths in Zimbabwe occur in infancy and Goromonzi district recorded 859 deaths in children under five years of age in 2012. The proportion of HIV exposed infants missing EID means pediatric ART cannot be scaled up. Factors associated with uptake of EID have to be established so as to increase pediatric ART and reduce childhood deaths. Methods: A 1:2 case control study was conducted. A case was defined as an infant resident and born in Goromonzi district from the 5th of November 2011 up to the 4th of November 2012 (attained eight weeks of age in 2012) to HIV infected mother and did not have HIV test at six to eight weeks of age in 2012. A control was defined as an infant resident and born in Goromonzi district from the 5th of November 2011 up to the 4th of November 2012 (attained eight weeks of age in 2012) to HIV infected mother and had an HIV test at six to eight weeks of age in 2012. Primary care givers of HIV exposed infants were recruited for interviews to establish factors associated with uptake of DBS test among infants in Goromonzi district. Results: 169 respondents were recruited, 54 were cases and 115 controls. Knowledge levels on HIV testing in infants among primary care givers were higher among controls than among cases (57% for cases, 79% for controls). Independent risk factors associated with non-uptake of HIV test among infants were belief that if a child is tested for HIV the child will be discriminated against O.R 3.61 (1.01; 12.9) and mother defaulted ART O.R 5.16 (1.48; 17.9). The independent protective factor associated with increased HIV test uptake was certainty on part of primary care giver that HIV test can be done to infants aged six to eight weeks in the district. Conclusion: Knowledge levels among controls were better than among cases. Risk factors for infants not taking HIV test at six to eight weeks of age were the belief that once a child is tested the baby will be discriminated against and a mother who defaulted ART. The protective factor associated with increased HIV test uptake was certainty on the part of primary care giver that an HIV test could be done to infants in Goromonzi district.