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Enhancing Early Infant Diagnosis Services for Improved HIV Outcomes

Explore the critical need to integrate Early Infant Diagnosis (EID) services, such as testing and treatment initiation, in comprehensive HIV care programs. Analyze data on post-testing attrition and mortality rates among HIV-exposed infants to identify gaps and necessary interventions to scale up EID services effectively.

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Enhancing Early Infant Diagnosis Services for Improved HIV Outcomes

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  1. Agenda Points for DiscussionScaling Up Early Infant Diagnosis SessionSUSS030318 July 2010, Vienna Matt Barnhart, UNICEF

  2. Of those infants testing HIV positive via EID, attrition post testing is significant (2008 data from multi-country review) Follow up of Infants Testing Positive via EID at Review Sites Uganda-72% not alive & on ART Cambodia- 67% not alive & on ART 100 3182 93 90 2330 Infants Infants 87 38 1170 33 878 No data Positive via EID Rec. Results Enrolled Initiated on ART Active on ART Positive via EID Results at Site Received Results/ Enrolled Initiated on ART Active on ART 2330 Senegal 67% not alive & on ART 27 14 Infants No data 6 4 Patients EID tested Patients lost Positive via EID Enrolled Received Results Initiated Alive on ART

  3. Less than one half of infants ever tested via EID across four countries were tested in their first two months of life in 2008. Coverage of the optimal service (early testing) was lower Portion of HIV Exposed Infants in Need Receiving EID Service in First Two Months of Life Missed early testing opportunities: PMTCT follow up appointments, vaccination schedule

  4. Key Points for Discussion • EID services must integrated into broader package of care and treatment for HIV-exposed infants • Paradigm shift away from vertical EID programs needed • Back to Basics: Cotrimoxazole and Infant Feeding • CTX coverage only 8% versus 15% for EID in multi-country reviews! • Stronger linkages to ART urgently needed • Need to improve organization of services at site-level. SOPs, QI approaches, and case management. • Laboratory expansion is not the optimal way in many cases to invest resources to improve outcomes for the end user. • National programs and partners should consider collection site and testing laboratory expansion carefully versus other investments in ensuring ART initiation occurs. • Point of care diagnostics urgently needed • But, while we await these, let’s improve the other components of care!

  5. Agenda Thank you!S Tripathi, C Kiyaga, M Nghatanga, M Chhi Vun, A S Wade, R Gass, A Chatterjee, R Ekpini, C Luo Please see “ART in Children: Programme Outcomes” Session TUPDB205 on Tuesday for fuller discussion of multi-country EID review.

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