AIDS and Behavior

, Volume 23, Issue 4, pp 1073–1083 | Cite as

“Closing the Gap”: Provider Recommendations for Implementing Birth Point of Care HIV Testing

  • Catherine Wexler
  • Yvonne Kamau
  • Ritika Halder
  • Melinda Brown
  • May Maloba
  • Natabhona Mabachi
  • Matthew SandbulteEmail author
  • Brad Gautney
  • Kathy Goggin
  • Thomas Odeny
  • Sarah Finocchario-Kessler
Original Paper


Delays in traditional HIV DNA PCR testing for early infant diagnosis (EID) at 6 weeks of age result in late antiretroviral treatment (ART). Birth point of care (POC) testing is an emerging strategy with the potential to streamline EID services. We elicited providers’ recommendations for introducing birth POC testing to guide strategies in Kenya and similar settings. We conducted formative interviews with 26 EID providers from four Kenyan hospitals prior to POC implementation. Providers discussed the need for comprehensive training, covering both EID and POC-specific topics for all key personnel. Providers highlighted equipment considerations, such as protocols for maintenance and safe storage. Providers emphasized the need for maternal counseling to ensure patient acceptance and most agreed that specimen collection for birth POC testing should occur in the maternity department and supported a multidisciplinary approach. Though most providers supported ART initiation based on a positive birth POC result, a few expressed concerns with result validity. To maximize implementation success, provider training, equipment security, maternal counseling, and logistics of testing must be planned and communicated to providers.


HIV testing Point of care Early infant diagnosis Implementation recommendations Birth testing 



The Kenya Medical Research Institute, Global Health Innovations, and Children’s Mercy Kansas City were collaborative partners in these efforts. We would like to acknowledge the members of the Study Team who played a key role in data collection and interview transcription: Mr. Martin Ochieng, Mr. Shadrack Babu, and Ms. Elizabeth Nyambura Muchoki. We are grateful to the providers who participated in the interviews. We also acknowledge the critical role of our government partners at the Kenya National AIDS and STI Control Program (NASCOP). We thank the Director of KEMRI for permission to publish this manuscript.


This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant Numbers R01HD076673 and R01HD076673S2).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Catherine Wexler
    • 1
  • Yvonne Kamau
    • 2
  • Ritika Halder
    • 2
  • Melinda Brown
    • 1
  • May Maloba
    • 3
  • Natabhona Mabachi
    • 1
  • Matthew Sandbulte
    • 1
    Email author
  • Brad Gautney
    • 4
  • Kathy Goggin
    • 5
    • 6
  • Thomas Odeny
    • 7
    • 8
  • Sarah Finocchario-Kessler
    • 1
  1. 1.Department of Family MedicineUniversity of Kansas Medical CenterKansas CityUSA
  2. 2.School of MedicineUniversity of Kansas Medical CenterKansas CityUSA
  3. 3.Global Health InnovationsNairobiKenya
  4. 4.Global Health InnovationsDallasUSA
  5. 5.Health Services and Outcomes ResearchChildren’s Mercy Kansas CityKansas CityUSA
  6. 6.University of Missouri- Kansas City School of MedicineKansas CityUSA
  7. 7.Kenya Medical Research InstituteNairobiKenya
  8. 8.School of MedicineUniversity of Missouri-Kansas CityKansas CityUSA

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