
Background: Paediatric ART coverage is only 20%, leaving a gap of 80%. The household members of HIV-positive persons often are also infected, but unfortunately, are frequently unaware of their HIV status. Early diagnosis and treatment of paediatric HIV is key as mortality of untreated patients is very high in the first two years of life and reaches 80% by four years. Methods: This descriptive cross-sectional study was conducted in two principal health facilities offering PMTCT/Paediatric HIV services in Calabar, Cross- River state, Nigeria. A “sibling” here is defined as a child from the same biological parents as the index patient. A pre-tested questionnaire was used to collect the baseline data, which included socio-demography, relationship to the child, and reasons for non-screening for HIV test were obtained. Results: Of the 401 children studied, 367(91.5%) had been previously tested for HIV while 34(8.5%) never had HIV test. The reasons observed for not testing and receiving care were low perception of risk for HIV (36.0%), fear of disclosure (29.2%), fear of stigmatization (22.4%), ignorance (7.9%) and distance from health facility (4.5%). Recommendations: Focused awareness campaigns and advocacy, evidence-based approaches should be sustained; laws that aim to reduce stigma and discrimination against people living with HIV should be enforced.