Pediatric and adolescent HIV testing and diagnosis in the context of COVID-19

Background: In 2019, UNAIDS estimated there were 150,000 new HIV infections among children ( 25% declines in HIV diagnoses for older adolescents, with Lesotho (-50%) and Zimbabwe (-49%) having the largest declines. While index testing for older adolescents decreased in most countries (-31%), it increased in Cameroon (+25%), Nigeria (+20%) and Cote d'Ivoire (+15%). Conclusion: Pediatric and adolescent HIV testing and diagnoses dramatically declined in many sub-Saharan African countries during the COVID-19 pandemic. Countries - like Cameroon, Cote d'Ivoire and Nigeria - that maintained or increased index testing during COVID-19 had the lowest declines in case finding. To mitigate the effects of COVID-19, programs may consider strategies to maximize index testing for children and adolescents (<19) of people living with HIV.