Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya
Background: Effective strategies to identify and screen children at risk for HIV are needed. The objectives of this study were to evaluate the utilization of a family information table (FIT) to identify and test at-risk children in Kenya and identify factors associated with child testing. Metho...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Global Health and Education Projects, Inc.
2014-09-01
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| Series: | International Journal of Maternal and Child Health and AIDS |
| Subjects: | |
| Online Access: | http://mchandaids.org/wp-content/uploads/2014/09/Evaluation-of-Family-Information-Table-in-Kenya.pdf |
| _version_ | 1818718326437707776 |
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| author | Michelle Meyer, BA Molly Elmer-DeWitt, BA Cinthia Blat, MPH Starley B. Shade, PhD Ijaa Kapule, MBChB Elizabeth Bukusi, MBChB, PhD Craig R. Cohen, MD Lisa Abuogi, MD |
| author_facet | Michelle Meyer, BA Molly Elmer-DeWitt, BA Cinthia Blat, MPH Starley B. Shade, PhD Ijaa Kapule, MBChB Elizabeth Bukusi, MBChB, PhD Craig R. Cohen, MD Lisa Abuogi, MD |
| author_sort | Michelle Meyer, BA |
| collection | DOAJ |
| description | Background: Effective strategies to identify and screen children at risk for HIV are needed. The objectives of this
study were to evaluate the utilization of a family information table (FIT) to identify and test at-risk children in Kenya
and identify factors associated with child testing.
Methods: A cross-sectional study was conducted among HIV-infected adults with children at five Kenyan clinics.
HIV testing status for children aged ≤18 years was gathered from the patients’ FITs and compared to reports from
in-person clinic visits as the gold standard. Generalized estimating equations were used to assess predictors for HIV
testing of children adjusted for confounders and within parent correlation.
Results: Our sample included 384 HIV-infected adults enrolled in care with 933 reported children. Overall, 323 FITs
(84%) correctly listed all children in the family and 340 (89%) documented an HIV testing status (including untested)
for all children. Seventy-five percent of parents verbally reported all children tested, compared to only 46% of FITs
(OR=13.5, 95% CI 6.5-27.8). Verbal reports identified 739 (79%) children tested, with 55 (7.4%) HIV-positive and
17 (2.3%) HIV-exposed infants (HEI). Of 63 adults with HIV-positive children or HEI, 60 (95%) reported enrolling
children into care. Likelihood that children had been tested was higher for younger children (≤4y vs. > 4y, aOR=2.0;
95% CI 1.4-2.9) and lower if the partner’s serostatus was unknown vs. seropositive (aOR=0.3; 95% CI: 0.1-0.8).
Conclusions: Although the FIT may be a useful tool to identify children at risk for HIV, this study found
underutilization by providers. To maximize impact of this tool, documentation of follow-up for untested and positive
children is essential.
Global Health Implications: Through early documentation of at-risk children and follow up of untested and
infected children, the FIT may serve as an effective resource for improving HIV testing and linkage to care. |
| first_indexed | 2024-12-17T19:49:16Z |
| format | Article |
| id | doaj.art-6e86c93be5a34257b6c044a335ec7d3d |
| institution | Directory Open Access Journal |
| issn | 2161-8674 2161-864X |
| language | English |
| last_indexed | 2024-12-17T19:49:16Z |
| publishDate | 2014-09-01 |
| publisher | Global Health and Education Projects, Inc. |
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| series | International Journal of Maternal and Child Health and AIDS |
| spelling | doaj.art-6e86c93be5a34257b6c044a335ec7d3d2022-12-21T21:34:47ZengGlobal Health and Education Projects, Inc.International Journal of Maternal and Child Health and AIDS2161-86742161-864X2014-09-0122236243Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in KenyaMichelle Meyer, BA0Molly Elmer-DeWitt, BA1Cinthia Blat, MPH2Starley B. Shade, PhD3Ijaa Kapule, MBChB4Elizabeth Bukusi, MBChB, PhD5Craig R. Cohen, MD6Lisa Abuogi, MD7School of Medicine, University of California, San Francisco, CA 94143, USASchool of Medicine, University of California, San Francisco, CA 94143, USASchool of Medicine, University of California, San Francisco, CA 94143, USA; nya Medical Research Institute (KEMRI), Family AIDS Care and Education Services (FACES), Kisumu, KENYADepartment of Medicine, University of California, San Francisco, CA 94143, USA; Kenya Medical Research Institute (KEMRI), Family AIDS Care and Education Services (FACES), Kisumu, KENYAKenya Medical Research Institute (KEMRI), Family AIDS Care and Education Services (FACES), Kisumu, KENYAKenya Medical Research Institute (KEMRI), Family AIDS Care and Education Services (FACES), Kisumu, KENYADepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Kenya Medical Research Institute (KEMRI), Family AIDS Care and Education Services (FACES), Kisumu, KENYADepartment of Pediatrics, University of California, San Francisco, CA 94143, USA; Kenya Medical Research Institute (KEMRI), Family AIDS Care and Education Services (FACES), Kisumu, KENYA; Department of Pediatrics, University of Colorado, Denver, CO 80045, USA (current affiliation)Background: Effective strategies to identify and screen children at risk for HIV are needed. The objectives of this study were to evaluate the utilization of a family information table (FIT) to identify and test at-risk children in Kenya and identify factors associated with child testing. Methods: A cross-sectional study was conducted among HIV-infected adults with children at five Kenyan clinics. HIV testing status for children aged ≤18 years was gathered from the patients’ FITs and compared to reports from in-person clinic visits as the gold standard. Generalized estimating equations were used to assess predictors for HIV testing of children adjusted for confounders and within parent correlation. Results: Our sample included 384 HIV-infected adults enrolled in care with 933 reported children. Overall, 323 FITs (84%) correctly listed all children in the family and 340 (89%) documented an HIV testing status (including untested) for all children. Seventy-five percent of parents verbally reported all children tested, compared to only 46% of FITs (OR=13.5, 95% CI 6.5-27.8). Verbal reports identified 739 (79%) children tested, with 55 (7.4%) HIV-positive and 17 (2.3%) HIV-exposed infants (HEI). Of 63 adults with HIV-positive children or HEI, 60 (95%) reported enrolling children into care. Likelihood that children had been tested was higher for younger children (≤4y vs. > 4y, aOR=2.0; 95% CI 1.4-2.9) and lower if the partner’s serostatus was unknown vs. seropositive (aOR=0.3; 95% CI: 0.1-0.8). Conclusions: Although the FIT may be a useful tool to identify children at risk for HIV, this study found underutilization by providers. To maximize impact of this tool, documentation of follow-up for untested and positive children is essential. Global Health Implications: Through early documentation of at-risk children and follow up of untested and infected children, the FIT may serve as an effective resource for improving HIV testing and linkage to care.http://mchandaids.org/wp-content/uploads/2014/09/Evaluation-of-Family-Information-Table-in-Kenya.pdfFamily information tablePediatricsHIV/AIDSLinkageKenyaHIV Testing |
| spellingShingle | Michelle Meyer, BA Molly Elmer-DeWitt, BA Cinthia Blat, MPH Starley B. Shade, PhD Ijaa Kapule, MBChB Elizabeth Bukusi, MBChB, PhD Craig R. Cohen, MD Lisa Abuogi, MD Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya International Journal of Maternal and Child Health and AIDS Family information table Pediatrics HIV/AIDS Linkage Kenya HIV Testing |
| title | Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya |
| title_full | Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya |
| title_fullStr | Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya |
| title_full_unstemmed | Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya |
| title_short | Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya |
| title_sort | evaluation and utility of a family information table to identify and test children at risk for hiv in kenya |
| topic | Family information table Pediatrics HIV/AIDS Linkage Kenya HIV Testing |
| url | http://mchandaids.org/wp-content/uploads/2014/09/Evaluation-of-Family-Information-Table-in-Kenya.pdf |
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