Departments of Epidemiology.
Global Health, University of Washington, Seattle, WA.
J Acquir Immune Defic Syndr. 2021 Jul 1;87(3):e229-e231. doi: 10.1097/QAI.0000000000002669.
: Index case testing (ICT) for children—testing children of HIV-positive index adults—reveals a high prevalence of undiagnosed pediatric HIV; however, uptake of ICT is sub-optimal.
: During recruitment for a randomized trial (NCT03049917), data were collected from sequential clients attending HIV care regarding whether they had children ages 0–12 years of unknown HIV status. We assessed male caregiver barriers to ICT and identified reasons children could not be tested for HIV through ICT.
: A higher proportion of males receiving HIV care reported untested children ≤12 years of age (7% [483/7,267]) compared to females (2% [358/15,008]; p<0.001). Among caregivers with untested children ≤12 years, 34% (166/483) of males and 89% (320/358) of females were eligible for ICT (p<0.001). Among caregivers who were ineligible for ICT, 29% (141/483) of male and 9% (31/358) of female caregivers were ineligible for ICT due to inability to physically access their children (p<0.001). A higher proportion of males than females did not have access to their children due to separation or divorce (82% [116/141] vs. 52% [16/31]). Overall, a higher proportion of male caregivers declined participation in the trial compared to females (11% [19/166] vs. 5% [15/320]; p=0.006), with 47% (9/19) of those males declining participation because they wanted to consult with their partner compared to 7% (1/15) of female caregivers (p=0.010).
: As programs scale up ICT, male caregiver barriers to ICT must be addressed to effectively reach untested children.
对艾滋病毒阳性成人的索引病例进行检测（ICT）可发现大量未确诊的儿科艾滋病毒；然而，ICT 的采用情况并不理想。
在一项随机试验（NCT03049917）的招募过程中，从连续就诊的艾滋病毒感染者中收集了关于他们是否有 0-12 岁未知艾滋病毒状况子女的数据。我们评估了男性照顾者进行 ICT 的障碍，并确定了无法通过 ICT 对儿童进行艾滋病毒检测的原因。
与女性（2%[358/15,008]）相比，接受艾滋病毒护理的男性报告有未接受检测的 12 岁以下儿童的比例更高（7%[483/7,267]；p<0.001）。在有未接受检测的 12 岁以下儿童的照顾者中，34%（166/483）的男性和 89%（320/358）的女性符合 ICT 条件（p<0.001）。在不符合 ICT 条件的照顾者中，29%（141/483）的男性和 9%（31/358）的女性由于无法接触到子女而无法接受 ICT（p<0.001）。由于分居或离婚，与女性相比，更多的男性无法接触到他们的子女（82%[116/141]与 52%[16/31]）。总体而言，与女性相比，更多的男性照顾者拒绝参加试验（11%[19/166]与 5%[15/320]；p=0.006），其中 47%（9/19）的男性拒绝参加是因为他们想与伴侣商量，而女性照顾者中只有 7%（1/15）拒绝参加（p=0.010）。
随着 ICT 计划的扩大，必须解决男性照顾者对 ICT 的障碍，以有效地接触到未接受检测的儿童。
