1. Getting to grips with testing children: protocols and procedures Justin Daniels North Middlesex Hospital December 2008

2. National Guidance UK National Guidelines for HIV Testing 2008 Any infant/child/young person thought to be at significant risk of HIV infection, including all those with parents or siblings who are HIV- infected, should be tested. It is in the best interest of the infant /child/young person to be tested in these circumstances although this only needs to be undertaken urgently in infants who are at risk of rapid disease progression.

3. The need for a clearer system How to translate this into action Adult tests positive Many factors We need to ensure children feature in this

4. So far… Protocol for referral Information leaflet – why your child needs a test Closer working between adult and paediatric team Clear guidance from social services

5. Positive male Does he have children? Does his partner know his diagnosis? Risk assessment Discuss with social services if necessary

6. Positive child / Indeterminate baby Do we know the status of all the other children in the family? Record names and dates of birth Where were they tested? If any doubt check and if necessary repeat

7. Looking backwards What do we know about adults under our care? What do we need to find out? How do we record this information?

8. Enabling this to happen Easier if coordinated adult and paediatric HIV teams If not – networks / shared protocols Importance of voluntary sector Inertia not an option!

9. How have we done? Several families reluctant All have been amenable to persuasion No referrals to social services so far!