Supply-side barriers restricting pediatric antiretroviral therapy (ART) access in sub-Saharan Africa are documented, but less is known about demand-side barriers, especially the health-seeking behaviors of parents and guardians on behalf of young children. Evidence suggests low uptake of pediatric ART where it is available, even in high prevalence areas, indicating that availability alone does not ensure that people are utilizing treatment services. In Kenya, while nearly half of the HIV-positive adults who need treatment are already receiving it, the proportion of eligible children receiving treatment is only 11 percent (Cherutich 2006; Koech 2006). This study explored and documented possible barriers in the community to accessing pediatric HIV testing and treatment in Kenya, to guide the development of new interventions to encourage uptake. Methodology Horizons conducted research in the catchment areas of six facilities offering pediatric HIV services in Nairobi, Eastern, and Nyanza provinces, Kenya. This included a population-based survey among households with children under age 15 years located within five kilometers of the facilities (n = 1,182, 52 percent female). Complementary qualitative and quantitative methods included focus group discussions (FGDs) and interviews with health workers, facility managers, and members of support groups for people living with HIV (PLHIV), and a health worker survey that included nurses, counselors, clinical officers, and doctors (n = 97).