Differentiated community-based point-of-care early infant diagnosis to improve HIV diagnosis and ART initiation among infants and young children in Zambia: A quasi-experimental cohort study

Introduction
An estimated 800,000 children (<15 years) globally living with HIV remain undiagnosed. To reach these children with timely HIV testing services during infancy, we implemented a community-based differentiated care model using mobile point-of-care (POC) technology for early infant diagnosis (EID) of HIV, and assessed its effects on EID positivity, antiretroviral therapy (ART) initiation, and 3-month retention in care.
Methods
Between 1 June 1, 2019— and 31 May 31, 2020 at six health facilities in Lusaka, Zambia, we enrolled mother-infant pairs (MIPs) at high risk for vertical transmission of HIV based on missing or late infant EID testing or other maternal risk factors. We offered these MIPs community POC EID testing (post-intervention), and compared their outcomes to historical high-risk controls at the same sites (1 June 1, 2017—–31 May 31, 2018; pre-intervention). We used propensity score matched weighting and mixed effects regression modeling to estimate outcome differ..., Data collection
All MIPs had the following routine data abstracted from their medical records: demographic information, maternal HIV status, infant HIV testing history, maternal ART history, infant ART history (if relevant), and follow-up visit dates. MIPs in the post-intervention cohort underwent study-specific data collection at enrolment and follow-up on HIV, obstetric, and infant clinical histories, EID testing history, and maternal and infant medication histories. All data were entered into a study database in Microsoft Excel (Redmond, WA, USA) for the pre-intervention period and OpenClinica for all data collected during the post-intervention period.
Study follow-up
Infants who tested as being HIV-positive through the study were followed for 12 weeks past enrollment to observe 3-month retention on ART and to complete a one-time study follow-up visit., , # Differentiated Community-Based Point-of-Care Early Infant Diagnosis to Improve HIV Diagnosis and ART Initiation among Infants and Young Children in Zambia: A Quasi-Experimental Cohort Study

[https://doi.org/10.5061/dryad.3bk3j9kwr](https://doi.org/10.5061/dryad.3bk3j9kwr)

## Description of the data and file structure

**Study setting and design**

We conducted a quasi-experimental pre-post study examining the effects of the community POC model at six health facilities and their surrounding communities (i.e., “sites”) in Lusaka, Zambia. The study sites were selected based on their comparable urban demography, catchment areas, and patient populations. All sites had similarly high annual volumes of pregnant and breastfeeding women (PBFW) living with HIV and infants who are HIV-exposed accessing prevention of vertical transmission of HIV services and infants living with HIV accessing ART. Each site is staffed by government healthcare workers, including nurses, clinicians, and laboratory...,