Top 5 Takeaways

  1. Significant Decrease in HIV Testing and Case Identification: The first months of the COVID-19 pandemic saw a 40.1% decrease in HIV testing and a 29.4% decrease in case identification among children and adolescents aged 1–14 years across 22 PEPFAR-supported (President’s Emergency Plan for AIDS Relief) countries.
  2. Shifts in Testing Strategies: While outpatient testing decreased by 21%, alternative strategies like mobile testing (38% increase), facility-based index testing (8% increase), and malnutrition clinics (7% increase) demonstrated potential to counteract pandemic-related disruptions.
  3. Disparities in Case Identification: A majority of tests (61.3%) and cases identified (60.9%) were among school-aged children (5–14 years), emphasizing the need for continued testing in older children.
  4. Recovery in Testing and Identification Rates: Post initial pandemic decrease, there was a 19.7% increase in testing and a 3.3% increase in case identification by the end of the study period, with some countries returning to or surpassing pre-pandemic levels.
  5. Optimizing Testing Strategies: The findings underline the importance of utilizing programmatic, surveillance, and financial data to optimize testing strategies, ensuring continued identification and treatment linkage of children living with HIV during the pandemic.

Original Article Author and Citation

Corresponding Author

Amy Medley,

Suggested Citation

Traub AM, Medley A, Gross J, et al. Pediatric HIV Case Identification Across 22 PEPFAR-Supported Countries During the COVID-19 Pandemic, October 2019–September 2020. MMWR Morb Mortal Wkly Rep 2022;71:894–898. DOI:


The report highlights the challenges faced in identifying and linking children living with HIV to treatment during the COVID-19 pandemic. A notable decrease in testing and case identification was observed, with varying impacts across different testing strategies and geographical regions.


Analysis involved monitoring, evaluation, and reporting indicators from 22 PEPFAR-supported countries. It focused on the number of HIV tests conducted and cases identified among children during the pandemic, with disaggregation by age group, testing strategy, and time.


The shift towards alternative testing strategies, such as mobile and facility-based index testing, suggests avenues to mitigate pandemic-related disruptions in pediatric HIV case identification. The recovery in testing rates towards the end of the study period indicates resilience and adaptability of HIV testing programs.


Despite initial setbacks, some progress was made in recovering pediatric HIV testing and case identification rates. The findings emphasize the need for continuous adaptation of testing strategies, informed by data analysis, to maintain and enhance pediatric HIV case identification during public health crises.


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