Provider-Initiated Testing and Counselling in Pediatric Units in Togo,2013-2014: Results of Two Years Implementation

Background: Voluntary testing and counselling rates remain low in Togo. UNAIDS/WHO/CDC have recommended provider-initiated testing and counseling (PITC) for HIV in settings with high HIV prevalence since 2007. We aimed to assess the first results of routine HIV testing in Paediatrian units after two years implementation in Togo. Method: Children (aged<15 years) who visited the 20 facilities selected were offered PITC for HIV. The intervention was implemented by trained health professionals for the period spanning. The implementation of the approach was first piloted between 2012 and 2014 in 20 health facilities. Results: The PITC strategy was highly acceptable (95% of mothers counselled) and increased the number of patients who tested for HIV. Within two years, the number of children who received an HIV testing increased by 3 folds (7,373 in 2013 to 22,656 in 2014). In the same period, the number of children tested for HIV positive increased significatively from 697 (9.5%) to 1,680 (7.4%) (p<0,0001). The sex ratio Male/female was 0.8 for HIV positive patients. Outpatient services (46%) accounted for half of the total number of tested children in the 20 facilities. High prevalence in tuberculosis services (19%), in the brotherly (9%) and outpatient services (8%), but low in Immunization services (5%) and PMTCT (5%) have been observed. A significant difference between the entry points and the HIV prevalence exists (p<0,0001). Conclusion: PITC for HIV was highly acceptable and resulted in an increased rate of HIV testing among children. The PITC strategy that facilitates early detection of HIV and referral for early treatment should be encouraged for broader HIV control and prevention in Togo communities.