Introduction In April 2019, 14 children were diagnosed with HIV infection by a private
healthcare provider in Larkana district, Sindh province, Pakistan. Over the next 3 months,
930 individuals were diagnosed with HIV,> 80% below 16 years, the largest ever outbreak of
HIV in children in Pakistan. In this protocol paper, we describe research methods for
assessing likely modes of HIV transmission in this outbreak and investigate spatial and
molecular epidemiology. Methods and analysis A matched case–control study will be …

Background: In April 2019, an HIV outbreak predominantly affecting children occurred in
Larkana District, Sindh, Pakistan. By December 2019, 881 of 21962 children screened had
tested positive for HIV. We conducted an individually-matched case-control study to
investigate risk factors for HIV infection. Methods: Cases (children aged< 16 years registered
for pediatric HIV care in Larkana city) and controls (HIV-uninfected children matched 1: 1 by
age, sex and neighbourhood) were sampled concurrently. An interviewer-administered …