{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:35:45Z","timestamp":1777300545322,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite global initiatives to improve access to life\u2010saving antiretroviral treatment (ART), only 54% of over 900,000 children living with HIV (CLHIV) received treatment in 2021, compared to 85% of women (WLHIV). Without timely ART, half of these children could die before age 2. We describe the design, implementation and outcomes of a child index case testing tool (cICT) that identifies WLHIV with untested children and embeds paediatric follow\u2010up into their HIV care to identify and test their untested children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The cICT was a card used to gather information about WLHIV and their children, including ages and HIV status (living with HIV, uninfected, exposed or unknown). Community health workers (CHWs) screened WLHIV 15 years and older at 95 ART clinics in Malawi from September 2020 to August 2023 and referred untested children to HIV testing services. De\u2010identified data were entered in SurveyCTO (Dobility, Inc., MA) to determine WLHIV screened, children's baseline HIV status, new HIV testing completed and newly identified CLHIV. Outcomes included reach (percentage of cohort offered screening), acceptability (percentage accepting cICT) and feasibility (percentage screened who completed child testing). Impact measured the proportion of women with untested children at baseline versus study conclusion, proportion of untested children tested; new CLHIV diagnosed and HIV testing yield.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of an estimated cohort of 116,000 WLHIV active in care, 101,273 were offered and screened (87% reach, 100% acceptability), 75,262 had at least one child 0\u201319 years old, with 24% (18,175\/75,262) of women having at least one child with unknown HIV status. At study conclusion, only 5% (4606\/101,273) of WLHIV had children with unknown status. A total of 193,402 children were listed among 75,262 WLHIV who identified as having children; 39,124 (20%) of the 193,402 children listed were untested. By study conclusion, 28,808\/39,124 (74%) of them were tested. Of these, 27,934 children were confirmed HIV uninfected, while 486 were newly diagnosed CLHIV, a 1.7% testing yield.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The cICT was acceptable and feasible to implement, revealing nearly a quarter of WLHIV had children with unknown HIV status. The tool's simplicity and scalability make it a high\u2010impact approach for HIV programmes to quantify, track and confirm the status of HIV\u2010exposed untested children and facilitate timely identification of CLHIV by embedding ICT screening within routine ART care for WLHIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70095","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:13:42Z","timestamp":1774588422000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reach, Acceptability, Feasibility and Impact of a Brief Community Health Worker\u2010Administered Index Case Testing Screening Tool \u201ccICT\u201d on Paediatric HIV Case Identification: Results From Malawi"],"prefix":"10.1002","volume":"29","author":[{"given":"Katherine R.","family":"Simon","sequence":"first","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Division of Global Health Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Masiano","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Kaonga","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhrutika","family":"Vansia","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Wetzel","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Division of Global Health Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elijah","family":"Kavuta","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Nyirenda","sequence":"additional","affiliation":[{"name":"Department of HIV STI and Viral Hepatitis Ministry of Health  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khumbo","family":"Namachapa","sequence":"additional","affiliation":[{"name":"Department of HIV STI and Viral Hepatitis Ministry of Health  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brown","family":"Chiwandira","sequence":"additional","affiliation":[{"name":"Department of HIV STI and Viral Hepatitis Ministry of Health  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie M.","family":"Cox","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Division of Global Health Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigid E.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Division of Global Health Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael","family":"Manyeki","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Division of Global Health Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linley","family":"Hauya","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Division of Global Health Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tapiwa A.","family":"Tembo","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"},{"name":"Division of Global Health Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"UNICEF 2021 HIV and AIDS Global Snapshot: Pregnant Women Children and Adolescents(2021)."},{"key":"e_1_2_12_3_1","unstructured":"New Report Reveals Stark Inequalities in Access to HIV Prevention and Treatment Services for Children\u2014Partners Call for Urgent Action. [Press Release]. 21 July 2021."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17140-7"},{"key":"e_1_2_12_5_1","unstructured":"UNICEF HIV\u2014Pediatric Care and Treatment(2021)."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000286597.57066.2b"},{"key":"e_1_2_12_7_1","unstructured":"UNICEF HIV\u2014Pediatric Care and Treatment(2019)."},{"key":"e_1_2_12_8_1","unstructured":"UNAIDS Global HIV & AIDS Statistics \u2010 2019 Fact Sheet. 2019 [cited 2024 17 January] https:\/\/www.unaids.org\/en\/resources\/fact\u2010sheet."},{"key":"e_1_2_12_9_1","unstructured":"UNICEF Child Survival and Development Brief(2024)."},{"key":"e_1_2_12_10_1","unstructured":"UNICEF HIV\u2014Paediatric Care and Treatment(2021)."},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001732"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26191"},{"key":"e_1_2_12_13_1","unstructured":"WHO Family\u2010Based Index Case Testing to Identify Children With HIV(2019)."},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001731"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003778"},{"key":"e_1_2_12_16_1","unstructured":"S.Essajee N.Putta S.Brusamento M.Penazzato S.Kean andD.Mark Family\u2010Based Index Case Testing to Identify Children With HIV(World Health Organization 2019)."},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-023-04485-1"},{"key":"e_1_2_12_18_1","unstructured":"UNICEF Technical Brief on Paediatric HIV Case\u2010Finding: Beyond Infant Testing(2024)."},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001184"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121003720986"},{"key":"e_1_2_12_21_1","unstructured":"Avert Children HIV and AIDS. [cited 2024 13 November] https:\/\/www.avert.org\/professionals\/hiv\u2010social\u2010issues\/key\u2010affected\u2010populations\/children."},{"key":"e_1_2_12_22_1","unstructured":"DHA MMoH Spectrum 2020 Preliminary Results(2020)."},{"key":"e_1_2_12_23_1","unstructured":"Ministry of Health and Population M Clinical Management of HIV in Children and Adults(2018)."},{"key":"e_1_2_12_24_1","unstructured":"Ministry of Health (MOH) M Malawi HIV Testing Services Guidelines(2016)."},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.1.19305"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.15.4.17389"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064979"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12900"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(21)00291-5"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001739"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002142"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0233590"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002500"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0132425"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003288"},{"key":"e_1_2_12_36_1","unstructured":"UNICEF HIV\u2014Paediatric Care and Treatment(2025)."},{"key":"e_1_2_12_37_1","unstructured":"UNICEF HIV\u2014Paediatric Care and Treatment (2025) https:\/\/data.unicef.org\/topic\/hivaids\/paediatric\u2010treatment\u2010and\u2010care\/."},{"key":"e_1_2_12_38_1","unstructured":"G.Cairns Finding the Missing Children: Paediatric Index Testing Expands in Africa(2010)."},{"key":"e_1_2_12_39_1","unstructured":"aidsmap (NAM AIDSmap) 2020 updated 10 July 2020 https:\/\/www.aidsmap.com\/news\/jul\u20102020\/finding\u2010missing\u2010children\u2010paediatric\u2010index\u2010testing\u2010expands\u2010africa."},{"key":"e_1_2_12_40_1","unstructured":"EGPAF Identifying Gaps in the Pediatric Index Testing Cascade in Homa Bay Kenya(2022)."},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(20)30267-8"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462420926344"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-022-03643-3"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2652-15-8"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181e9e069"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181f0758f"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.70095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T13:38:50Z","timestamp":1777297130000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.70095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":45,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/jia2.70095"],"URL":"https:\/\/doi.org\/10.1002\/jia2.70095","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"2025-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70095"}}