CHALLENGES FOR EARLY INFANT DIAGNOSIS OF HIV IN THE GBEKE HEALTH REGION, IN CENTRAL COTE D'IVOIRE

Abstract

In low income countries, 35% of HIV infected infants will die within a year if they are not tested and treated early for HIV infection. Identifying and tracking HIV exposed infants remains a significant challenge for many countries, meaning up to 80% of HIV exposed infants are estimated to be lost to follow up and do not receive critical, lifesaving interventions. This study focused on the facilitators and barriers of early infant diagnosis of HIV at six clinics of the Gbêkê region in Côte d'Ivoire. Quantitative and qualitative methods were used to answer research questions related to community, health system, and individual level facilitators and barriers to accessing early infant diagnosis (EID) services in public health facilities. Key findings reveal that challenges such as unpredictable turnaround time for the return of HIV test results and fear of stigma are important barriers to early infant diagnosis. Facilitating factors include the presence of on-site community counselors, who played key roles in the retention of caregivers into care and treatment services. Recommendations for improving EID services in clinics include more systematic application of national guidelines related to the organization of onsite services, greater government support for the role of community counselors in public health facilities, and a decentralization of virologic testing machines to reduce the turnaround time of test results for HIV exposed infants.