In 2012, 260 000 new cases of human immunodefi-ciency virus (HIV) infection in children occurred in sub-Saharan Africa, primarily due to mother-to-child transmission of HIV. 1 However, childhood HIV infection can be prevented by the implementation of prevention of mother-to-child transmission (PMTCT) strategies. PMTCT 'Option B+' originated in Malawi in July 2011. 2–5 With Option B+, all pregnant and breastfeed-ing women are offered HIV testing and counselling, and those who are HIV-infected are offered life-long antiretroviral treatment (ART) with tenofovir/lamivu-dine/efavirenz. 2,6 HIV-exposed infants receive nevirap-ine from birth until 6 weeks of age. 2,6 National guide-lines recommend that all HIV-exposed infants undergo HIV DNA polymerase chain reaction (PCR) testing 6–8 weeks after birth and rapid HIV testing (RHT) at 12–24 months of age, and that those with HIV infection be started on ART immediately. 4,6 Option B+ was endorsed by the World Health Orga-nization (WHO) in 2012 and included in the 2013 WHO ART guidelines. 3 By June 2013, 588 health facili-ties were offering Option B+ in Malawi. 7 A seven-fold increase in the number of women ini-tiated on ART in the first year of Option B+ in Malawi was documented, with 77% retained in care at 12 months. 8 More evidence, however, is needed on the management of HIV-exposed infants under routine conditions of Option B+ implementation. 2,3,9 The aim of this study was to evaluate programme retention and uptake and timing of HIV testing among infants born to HIV-infected mothers enrolled in Option B+ at Thyolo District Hospital (TDH).