Peds — SAIA

The UNAIDS 95-95-95 goals—which aim for 95% diagnosed, 95% on treatment, and 95% virally suppressed—are far from being met for children living with HIV.

Pediatric HIV in Kenya

In Kenya, 60% of HIV-infected children are undiagnosed, just 41% are on treatment, and data on rates of viral suppression are not reliable. Undiagnosed and untreated pediatric HIV infection results in high morbidity and mortality, as well as long-term impacts on growth and development. Pediatric HIV testing occurs in multiple settings with diverse systems-level challenges, but feed into the same treatment systems, and approaches to scale and optimize diverse systems for prompt testing, linkage to care and treatment initiation are needed to maximize the benefit of pediatric HIV treatment and limit morbidity and mortality.

Global targets for pediatric HIV are far from being met globally, leading to avoidable deaths. In the absence of prompt testing and access to anti-retroviral therapy (ART), approximately half of HIV-infected children will die before 2 years of age. Additionally, ART improves developmental outcomes such as growth and neurocognitive development, and survival and development benefits are greatest when treatment is initiated early and adhered to well. Recently, the SAIA strategy was adapted to describe key service steps along the pediatric HIV testing and linked care cascade (SAIA-Peds), covering uptake of HIV testing, linkage to HIV care, ART initiation and viral load monitoring and suppression. The subsequent SAIA-PEDS pilot in six clinics in central and western Kenya used a mixed methods evaluation to prepare for a follow-on effectiveness trial of the SAIA-PEDS adaptation.