By Hloniphile Mabuza
Building Local Capacity for Delivery of HIV Services in Southern Africa Project, MSH South Africa
Earlier this week, I attended a session on monitoring and evaluation, and one of the presentations was on “Analysis of the effect of universal PITC [provider-initiated testing and counseling] of all babies at 18 months of age regardless of history of HIV exposure.” This was a pre/post study conducted in the Ugu district in KwaZulu-Natal, South Africa. The Department of Health in Ugu developed a protocol to test all babies at 18 months when they come for their measles immunization. The study revealed that in the nine months before the protocol was introduced (from October 2011-June 2012), only 18.1% of babies were tested and the HIV prevalence among babies 18 months old was 1.03%. During the nine months after the protocol was introduced (July 2012-March 2013), 42.8% of babies were tested and the HIV prevalence increased to 1.68%. There was no mention if this was statistically significant or not. The study recommended robust implementation of universal HIV testing at 18 months regardless of HIV exposure.
As I listened to the presentation and discussion, more questions came to mind: Is this really the best way to conduct pediatric HIV screening? How much would it cost South Africa to implement this strategy, and is it the most efficient use of funding, considering the HIV prevalence both before and after the study protocol was less than 2%?
Let’s hear other thoughts – reply below to join the discussion.