HIV testing rates, female caregivers’ reasons to test and not to test the children in Maseru Community Council, Lesotho.

Abstract

Prevention of mother to child transmission (PMTCT) program offer a range of services for women of reproductive age with or at risk of acquiring human immunodeficiency syndrome (HIV). In reality, there are missed opportunities along the PMTCT cascade for different reasons. We investigated the reasons to test and not to test children under five years and determined the caregiver factors associated with uptake of HIV testing among children. This was a cross sectional survey of caregivers of children attending maternal neonatal child health (MNCH) clinics in three health facilities within Maseru community council (MCC). The study used questionnaire to collect data; under the history of HIV testing all caregivers were asked if the children had ever tested for HIV. Reasons for testing and not testing children for HIV were asked to all caregivers and documented. A total of 202 caregivers of children attending MNCH services participated in the survey, with the mean age of 29 years (SD 7.7). The majority 91.1% (n=184) of children were brought to health facility by their biological parent. Fifty-four percent of children were tested for HIV with 9.2% (n=10) HIV positivity rate. Reasons for non-uptake of HIV testing in children under five years were mainly care giver related (lack of caregiver knowledge that the child needed to test for HIV, mum busy and the caregiver did not take child for testing). HIV testing uptake of children was strongly related to age of caregiver. Generally, HIV testing among children is accepted; but non uptake of HIV testing for children by the caregivers still persists. Practices of HIV testing for children are affected by different challenges despite the scale up of the prevention of mother to child transmission. Results points that older caregivers were more likely to have their children tested for HIV. The results from our study adds value to HTS programs to tailor HTS messages for different caregivers.