Over the first 12 months of implementation, the PITC program offered HIV testing to 45.2% of admissions, or 10,245 mothers and their hospitalized children, representing a four-fold increase in comparison to pre-PITC estimates1. 98.7% of mother-child pairs accepted testing, and we observed the HIV prevalence of hospitalized children to be 8.5%, nearly two-fold higher than the estimated community pediatric prevalence of 4.8% in Malawi. Furthermore, 73.9% of HIV+ hospitalized children had not yet accessed ART , despite over 70% of these patients clinically or immunologically eligible. The program also completed 476 DBS tests during the same time period, representing the highest volume EID site in Malawi, with 40.1% testing positive.