Delayed HIV status identification and associated factors among HIV exposed children in Lindi region

Abstract

ABSTRACT Background: The rate of HIV exposed children missing the opportunity of early HIV status identification world wide is progressively worsening from 58% in 2016 to 64% in 2017. In Tanzania, 58% of HIV exposed infants delayed receiving HIV status identification services in 2016. There is limited knowledge on the factors affecting delayed HIV testing among HIV exposed children in the remote areas of Tanzania. Objective: To assess the proportion with delayed HIV status identification among HIV exposed children and associated factors in Lindi region. Methodology: A cross sectional health facility-based study was done from March to April 2019 involving four councils and 15 health facilities. Subjects meeting the inclusion criteria from the selected health facilities were consecutively recruited and interviewed. Univariate and multivariate logistic regression analysis was done to examine the association of socio-demographic and clinical factors with delayed HIV status identification. Results: A total of 231 HIV exposed children were sampled for this study. The mean age of their mothers was 32.9 years (standard deviation of 6.5 years). All exposed children had their DNA PCR sample collected by the time of the study whereby 98 (42.4%) received DNA PCR testing at the age more than two months hence delayed HIV status identification. Twelve (5.2%) out of 231 children were HIV positive. Mothers’ primary level of education (adjusted odds ratio= 2.1, 95% CI =1.09 – 4.09) and less than 4 antenatal clinic visits status during pregnancy (adjusted odds ratio = 2.17, 95% CI=1.19 – 3.95) were associated with delayed HIV status identification among HIV exposed children. Conclusion and Recommendation: Four out of ten HIV exposed children delayed HIV status identification in Lindi region. Delayed HIV status identification among exposed children was associated with less than four maternal ANC visits during pregnancy and maternal primary level of education. In order to improve delayed HIV status identification among exposed children, continuous health education on the timing of the early infant diagnosis and the significance of completing four standard antenatal visit, should be provided to all HIV positive women of reproductive age before conceiving, during pregnancy and throughout breastfeeding period.