Two alternatives that could potentially strengthen EID and pediatric ART access are the routine use of presumptive diagnosis (PD), or a clinical HIV diagnostic algorithm in young children, as an adjunct to DBS and definitive inpatient virologic testing that provides results before hospital discharge ("expedited PCR") instead of PD and DBS. This research proposal primarily aims to validate PD testing as well as assess the impact of PD and expedited PCR upon patient outcomes within the established inpatient pediatric HIV testing system at KCH.