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P142 Challenges and opportunities of a ‘Look Back’ exercise on child testing
  1. Racheol Sierra,
  2. Vasuki Selvadurai,
  3. Judith Zhou
  1. Western Sussex Foundation NHS Trust, Worthing, UK

Abstract

Background/introduction The consensus document ‘Don’t forget the children’ 2009 recommends that all HIV units perform a ‘look back’ exercise to establish the HIV status of children whose HIV positive parents attend that service, as a standard of care.

Aim(s)/objectives To perform a ‘look back’ to identify children born to HIV positive females in our unit. Determine their HIV testing status and establish a robust pathway for testing and recording outcome.

Methods A retrospective notes review of all HIV positive women registered with the Sexual Health Clinic.

Results 76 women identified, 66 had 149 children. Ethnicity was predominantly African (38/76). 48/76 women acquired infection abroad. Children at risk of vertical HIV transmission recognised in 53/66 women. Child testing identified and documented in 29/53 women (65 children); 8 were HIV positive. 10/53 had children resident abroad (23 children). Parental discussions on-going in 6/53 women. A further 3/53 women declined testing. In 3/53 records were incomplete and 2/53 testing in progress.

Discussion/conclusion Challenges of retrospectively identifying children at risk of undiagnosed HIV highlighted particularly in parents that have not disclosed their status to children. We identified a reliance on verbally reported documentation as evidence of child testing, the challenges of testing older children and the need for robust reporting between paediatric and adult services. Clinicians should continue to ask about children abroad who subsequently join parents in the UK to avoid missed opportunities for testing.

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