{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:09:38Z","timestamp":1740146978516,"version":"3.37.3"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["7200AA19CA00002"],"award-info":[{"award-number":["7200AA19CA00002"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","award":["7200AA19CA00002"],"award-info":[{"award-number":["7200AA19CA00002"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Children of key population individuals (CPK) often face the same stigma and discrimination as their parents, limiting their access to HIV services. The Meeting Targets and Maintaining Epidemic Control project analyzed pediatric HIV testing data from project-supported sites to better understand risk among CKP and improve comprehensive prevention, testing, and treatment for KP families.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a retrospective analysis of routine program data collected October 1, 2021\u2013September 30, 2022, in project-supported sites in Burundi, C\u00f4te d\u2019Ivoire, Democratic Republic of Congo, Tanzania, and Togo. We compared HIV case finding (defined as the percentage of children diagnosed with HIV among those who were tested) and treatment initiation (defined as the percentage of children diagnosed with HIV who were initiated on antiretroviral therapy) data for children &lt;15 years disaggregated by index versus non-index testing and CKP versus children of non-KP individuals (non-CKP).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 5,651 children were tested (n = 2,974 index testing; n = 2,677 non-index testing). Of those diagnosed with HIV, 33% (181\/541) were CKP, with case finding 17% (181 positive\/1,070 tested) among CKP and 8% among non-CKP (360 positive\/4,581 tested). Almost half of CKP diagnosed were ages 1\u20134 years. Among the 2,974 (53%) reached through index testing, overall case finding was higher among CKP (17%; 178 positive\/1,052 tested) than non-CKP (11%; 219 positive\/1,922 tested). Treatment initiation was 97% among CKP and 94% among non-CKP.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>CKP were identified primarily through index testing which, although considered a priority strategy to identify children at high risk, has not been widely used within KP family networks. Most CKP reached were children of female sex workers, but those of other KPs should also be prioritized.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>KP-focused programs have often excluded children, but the case-finding approaches in the project\u2019s KP programs were effective in reaching CKP. Comprehensive, family-centered KP programming is needed that includes family planning, prevention of vertical transmission, early infant diagnosis, and other maternal and child health services to reduce the impact of HIV on families and achieve an HIV-free generation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0309847","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T17:43:36Z","timestamp":1725644616000},"page":"e0309847","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Are children of key population individuals at higher risk of HIV than other children? Results from a multi-country analysis of routine program data"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2684-6269","authenticated-orcid":true,"given":"Caterina","family":"Casalini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Yeiser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Amanuel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Gottlieb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Akolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madje Koffivi","family":"Toovi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dismas","family":"Gashobotse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Mabanza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Ogwang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Georges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Mack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meena","family":"Srivastava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"year":"2019","author":"M Srivastava","key":"pone.0309847.ref001"},{"volume-title":"Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations.","year":"2022","author":"World Health Organization (WHO).","key":"pone.0309847.ref002"},{"volume-title":"Fact sheet: global HIV statistics.","year":"2023","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS)","key":"pone.0309847.ref003"},{"journal-title":"Key populations: UNAIDS.","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).","key":"pone.0309847.ref004"},{"volume-title":"In danger: UNAIDS global AIDS update 2022.","year":"2022","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).","key":"pone.0309847.ref005"},{"volume-title":"Nigeria children of people who inject drugs project final report: July 1-December 30, 2020.","year":"2021","author":"Meeting Targets and Maintaining Epidemic Control (EpiC).","key":"pone.0309847.ref006"},{"key":"pone.0309847.ref007","first-page":"S91","article-title":"An urgent need for integration of family planning services into HIV care: the high burden of unplanned pregnancy, termination of pregnancy, and limited contraception use among female sex workers in C\u00f4te d\u2019Ivoire.","volume":"68","author":"S Schwartz","year":"2015","journal-title":"JAIDS"},{"journal-title":"From shadows to light: advocacy for children of HIV-affected key populations: The Coalition of Children Affected by AIDS","year":"2016","author":"J. Miller","key":"pone.0309847.ref008"},{"journal-title":"Reminagining PEPFAR\u2019s strategic direction: fulfilling America\u2019s promise to END the HIV\/AIDS pandemic by 2030.","year":"2022","author":"U.S. President\u2019s Emergency Plan for AIDS Relief (PEPFAR).","key":"pone.0309847.ref009"},{"volume-title":"PEPFAR guidance on implementing safe and ethical index testing services.","year":"2020","author":"U.S. President\u2019s Emergency Plan for AIDS Relief (PEPFAR).","key":"pone.0309847.ref010"},{"volume-title":"Assessing HIV prevalence and health outcomes of children of female sex workers in Port Elizabeth, South Africa to guide PMTCT programming for vulnerable populations.","year":"2017","author":"S Schwartz","key":"pone.0309847.ref011"},{"volume-title":"High prevalence of HIV among wives of married men who have sex with men in India","year":"2016","author":"AK Srikrishnan","key":"pone.0309847.ref012"},{"issue":"Suppl 2","key":"pone.0309847.ref013","first-page":"S7","article-title":"The impact of HIV and high-risk behaviours on the wives of married men who have sex with men and injection drug users: implications for HIV prevention.","volume":"13 Suppl 2","author":"SS Solomon","year":"2010","journal-title":"J Int AIDS Soc"},{"issue":"8","key":"pone.0309847.ref014","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1080\/13691058.2017.1390161","article-title":"HIV risks among women who are married to men who have sex with men in India: a qualitative investigation.","volume":"20","author":"C Tomori","year":"2018","journal-title":"Cult Health Sex"},{"issue":"1","key":"pone.0309847.ref015","doi-asserted-by":"crossref","first-page":"e0169482","DOI":"10.1371\/journal.pone.0169482","article-title":"Gender differences in factors related to HIV risk behaviors among people who inject drugs in North-East India.","volume":"12","author":"B Sabri","year":"2017","journal-title":"PLoS One"},{"issue":"Suppl 2:","key":"pone.0309847.ref016","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1097\/QAI.0000000000000454","article-title":"Mothers who sell sex: a potential paradigm for integrated HIV, sexual, and reproductive health interventions among women at high risk of HIV in Burkina Faso.","volume":"68","author":"E Papworth","year":"2015","journal-title":"J Acquir Immune Defic Syndr"},{"journal-title":"Prevention of mother-to-child transmission of HIV in prisons: a technical guide","year":"2020","author":"United Nations Office of Drugs and Crime","key":"pone.0309847.ref017"},{"issue":"Suppl 1","key":"pone.0309847.ref018","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12978-019-0716-7","article-title":"Antenatal care presentation and engagement in the context of sex work: exploring barriers to care for sex worker mothers in South Africa.","volume":"16","author":"L Parmley","year":"2019","journal-title":"Reprod Health"},{"issue":"Suppl 2","key":"pone.0309847.ref019","doi-asserted-by":"crossref","first-page":"S224","DOI":"10.1097\/QAI.0000000000001375","article-title":"The roles of expert mothers engaged in prevention of mother-to-child transmission (PMTCT) programs: a commentary on the INSPIRE studies in Malawi, Nigeria, and Zimbabwe.","volume":"75","author":"F Cataldo","year":"2017","journal-title":"J Acquir Immune Defic Syndr"},{"volume-title":"Addressing children of key populations.","year":"2018","author":"OoHACoK Taskforce","key":"pone.0309847.ref020"},{"issue":"1","key":"pone.0309847.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09540121.2014.946384","article-title":"Vulnerabilities faced by the children of sex workers in two Mexico-US border cities: a retrospective study on sexual violence, substance use and HIV risk","volume":"27","author":"AE Servin","year":"2015","journal-title":"AIDS Care"},{"issue":"S1","key":"pone.0309847.ref022","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/09540120902923121","article-title":"Strengthening families to support children affected by HIV and AIDS","volume":"21 Suppl 1","author":"LM Richter","year":"2009","journal-title":"AIDS Care"},{"issue":"9998","key":"pone.0309847.ref023","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0140-6736(15)00134-8","article-title":"Coalition for Children Affected by A. 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