title: Dynamics and constraints of early infant diagnosis of HIV infection in Rural Kenya.
abstract: A cohort design was used to determine uptake and drop out of 213 HIV-exposed infants eligible for Early Infant Diagnosis (EID) of HIV. To explore service providers and care givers knowledge, attitudes and perceptions of the EID process, observations and in-depth interviews were conducted. 145 (68%) infants enrolled after 2 months of age. 139 (65%) dropped out before follow up to 18 months old. 60 (43%) drop outs occurred within 2 months of enrolment. Maternal factors associated with infant drop out were maternal loss to follow up (48 [68%] vs. 8 [20%], P < 0.001) and younger maternal age (27.2 vs. 30.1 years, P = 0.033). Service providers and caregivers had inadequate training, knowledge and understanding of EID. Poverty and lack of social support were challenges in accessing EID services. EID should be more closely aligned within PMTCT services, integrated with routine mother and child health (MCH) activities and its implementation more closely monitored.
authors.affiliation: Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya.
authors.forename: Amin S
authors.initials: AS
authors.lastname: Hassan
authors.forename: Erick M
authors.initials: EM
authors.lastname: Sakwa
authors.forename: Helen M
authors.initials: HM
authors.lastname: Nabwera
authors.forename: Miriam M
authors.initials: MM
authors.lastname: Taegtmeyer
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kimutai
authors.forename: Eduard J
authors.initials: EJ
authors.lastname: Sanders
authors.forename: Ken K
authors.initials: KK
authors.lastname: Awuondo
authors.forename: Maureen N
authors.initials: MN
authors.lastname: Mutinda
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Molyneux
authors.forename: James A
authors.initials: JA
authors.lastname: Berkley
mesh_terms: D000328:Adult; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis*; D015497:HIV-1 / Q000302:isolation & purification; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007407:Interviews as Topic; D007630:Kenya; D008297:Male; D008423:Maternal Age; D016133:Polymerase Chain Reaction; D012424:Rural Population; D012944:Social Support; D012959:Socioeconomic Factors