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

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, 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.