Implementation of blanket provider-initiated testing and counselling: Predictors of HIV seropositivity among infants, children and adolescents in Cameroon

Abstract Objectives The number needed to test (NNT) to identify a child infected with HIV remains high in the context of the implementation of the blanket provider-initiated testing and counselling (bPITC) strategy. This study assessed the predictors of HIV seropositivity among outpatient children/adolescents (6 weeks-19 years) in Cameroon. This information is needed to improve the yield of bPITC and reduce the current gap in pediatric and adolescent ART coverage in this country and beyond. Study Design Cross-sectional study conducted in 3 hospitals in Cameroon. Methods Through biological parents and guardians we systematically invited children and adolescents visiting the outpatient departments for any reason to test for HIV (bPITC) in a 6-month period. Children and adolescents were tested for HIV following the national guidelines and the predictors of HIV seropositivity were assessed using multivariate logistic regression at 5% significant level. Results A total of 2729 eligible children/adolescents were enrolled. Among these, 90.3% (2465/2729) were tested for HIV. Out of these, 1.6% (40/2465) tested HIV-positive, corresponding to a NNT of 62. In multivariate analysis, HIV seropositivity was 2.5, 3.3, and 5 times more likely to be reported among children/adolescents of the female sex [aOR=0.4 (0.2-0.8), p=0.008]; whose fathers had no formal school education [aOR=0.3 (0.1-0.6), p=0.004] and those whose mothers had died [aOR=0.2 (0.0-0.9), p=0.041], respectively. Conclusions Focusing HIV testing among female children/adolescents of the female sex, whose fathers had no education level and whose mothers had died could reduce the NNT, improve the yield of bPITC and increase the pediatric and adolescent ART coverage.