Particular Considerations for HIV Testing
HIV infection is an established risk factor for pneumonia in
general and for pneumonia caused by specific pathogens such as
Mycobacterium tuberculosis, Pneumocystis jirovecii, pneumococcus,
and Hib [29]. HIV infection status is therefore an important
variable to assess as a potential confounder of other risk factors.
Despite efforts to introduce routine HIV testing in developing
countries, it remains a sensitive issue and many mothers and
children remain untested in high-HIV prevalence areas. Furthermore,
in areas with very low HIV prevalence, the value of
identifying perhaps one child in a thousand who is infected may
be outweighed by the disadvantage of negative community reaction
to such a survey. After considerable debate, we reached
a consensus position that all PERCH subjects would be tested for